To Evaluate the analgesic efficacy of the anterior femoral cutaneous nerve block (AFCNB) combined with the adductor canal block (ACB) in patients undergoing unilateral total knee replacement (TKR) : A randomized controlled trial

Pain management is a fundamental aspect of patient care after orthopaedic surgery. As surgical techniques continue to advance, so do the methods of perioperative pain control. Among the many strategies for postoperative analgesia, peripheral nerve blocks have gained recognition as effective tools in reducing pain and opioid consumption, and promoting early ambulation after Total Knee Replacement (TKR) surgeries. Adductor canal block (ACB) has shown promise in providing effective pain relief and is motor sparing as it targets the sensory division of the femoral nerve (Saphenous nerve). However, some recent studies have shown that it covers only limited area of the incision site and provide only partial analgesia[1]. Blocking, the Intermediate and Medial cutaneous nerve together known as the Anterior femoral cutaneous nerve, that covers the supply of anterior and medial aspect of thigh and knee has shown to provide excellent analgesia in one of the studies. However, further studies are needed to overcome the limitations and provide additional evidence of the benefit of combining Anterior femoral cutaneous nerve block (AFCNB) with Adductor canal block (ACB).

This study aims to evaluate the analgesic efficacy of the AFCNB combined with the ACB versus adductor canal block (ACB) alone in patients undergoing TKR surgeries. It will shed light on the optimal technique for improved postoperative pain management and patient satisfaction. This study also endeavours to address a significant gap in current knowledge and inform clinical practice, ultimately enhancing the quality of care for patients after total knee replacement.