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At least 181 records · Page 10Linked to original sources
PubMed2026

Adductor Canal Block and Local Anesthetic Versus Local Anesthetic Alone in ACL Reconstruction: A Double-Blind Randomized Controlled Trial.

BACKGROUND: Effective postoperative analgesia is crucial for early recovery after anterior cruciate ligament reconstruction (ACLR). Local infiltration analgesia (LIA) and adductor canal block (ACB) are common regional techniques, but their combined efficacy remains unclear. PURPOSE: To compare the effectiveness of LIA alone versus LIA combined with ACB in patients undergoing ACLR, with primary outcomes including postoperative opioid consumption and quadriceps function. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A double-blind randomized controlled trial enrolled 100 patients undergoing ACLR under general anesthesia. Patients were randomized into 2 groups: LIA + sham (saline injection) (n = 50) and LIA + ACB (n = 50). The primary outcome was postoperative opioid consumption in the first 24 hours. Secondary outcomes included visual analog scale (VAS) pain score, quadriceps function assessed by straight leg raise (SLR) at 3 hours, Quality of Recovery-15 (QoR-15) score, and Knee Injury and Osteoarthritis Outcome Score (KOOS) at 1 week. Statistical analysis was performed using t tests and chi-square tests with a P value <.05 considered significant. RESULTS: There was no significant difference in 24-hour opioid consumption between the LIA + ACB and LIA-only groups (P = .109). Similarly, VAS pain scores at 24 hours postoperatively showed no significant differences between the groups (P = .0804). Early functional recovery, assessed by SLR performance at 3 hours, was equivalent between groups (P = .6711). Additionally, QoR-15 scores on postoperative day 1 and KOOS values at 1 week demonstrated no significant differences (P = .6486 and P = .9054, respectively). Intraoperative opioid consumption was not different between the groups (P = .127). CONCLUSION: These findings indicate that the addition of ACB to LIA does not yield postoperative analgesic in ACLR. Consequently, LIA alone suffices for routine ACLR, potentially enabling clinicians to optimize perioperative workflows without incurring the additional time, financial burden, and resources associated with routine ACB administration. TRIAL REGISTRATION: ClinicalTrials.gov; NCT04721119.

Humans↗
PubMed1999

[The use of tranexamic acid as an anesthetic component in ENT surgeries in patients with high surgical-anesthetic risk and in hemorrhagic shock intensive therapy].

Experimental and clinical trials have shown that anesthesia and intensive therapy of shock incorporating tranexamic acid enhance analgesia, hyporeflexia, thus ensuring stable, adequate anesthesia which is safe under reduced doses of standard anesthesiological modalities. Application of tranexamic acid provided more favourable course of postanesthesiological and postoperative periods, decreased the number of complications and lethal outcomes compared to standard anesthesia.

Adult↗
PubMed1999

[Brain damage caused by hypotensive anesthesia? Both the anesthetic technique and the anesthetic agent must be chosen with care].

During the fifty years since hypotensive anaesthesia, induced hypotension to minimise intraoperative blood loss, became an established routine, there have been few reports of associated cerebral complications. However, evidence of disturbed cerebral function among patients undergoing orthognathic surgery under induced hypotension was obtained in a recent study where the level of adenylate kinase activity in cerebrospinal fluid was used as a highly sensitive biochemical marker of brain cell injury. Moreover, psychometric tests revealed persistent postoperative mental deterioration. The underlying cause of brain cell injury seems to be complex, and as in all likelihood it is not hypotension per se that is responsible, the effect of the anaesthetic agents used (isoflurane and propofol) has to be considered. It was also noted that hypotension did not improve the clinical outcome of orthognathic surgery, as compared with comparable operations performed under normotension.

Adenylate Kinase↗
PubMed1999

[Studies of local anesthetics. CL. Models of the dependence of local anesthetic effectiveness of basic esters of alkoxy-substituted phenylcarbamic acids on capacity factor k'].

On the basis of proposed six models of the dependence of local anaesthetic effectiveness of series of alkoxysubstituted derivatives of phenylcarbamic acid, this activity was studies in dependence on the capacity factor k' as the parameter of lipophilicity. The most suitable models proved to be y = (Cx + Ci).k' for surface anaesthesia, and y = Cx + Ci log k' for infiltration anaesthesia, y being the value of the decadic logarithm of surface or infiltration local anaesthetic activity, Cx the coefficient characterizing the nitrogenous base, Ci the coefficient characterizing the individual alkoxygroups, and k' the capacity factor from HPLC.

Anesthetics, Local↗