الفهرس 
Table of ContentsOnly 14 pages are availabe for public view
 |  | from | 85 |  |  |
| | | from | 85 | | |
Abstract
After approval from local medical and ethical committee in faculty of medicine, Mansoura University, this randomized controlled study was done in Emergency Hospital, patients were interviewed and written consent was obtained from all patients. 99 patients with American Society of Anesthesiologists (ASA) physical status I - II of both sexes aged from 20-60 years were scheduled for elective unilateral fractures around & below knee and classified into three equal groups (n=33 each): Control group (group 1): with injection of normal saline in the adductor canal. Adductor canal block group (ACB group) (group 2): having injection of levobupivacaine 0.25 %( 20 ml) slowly injected in the adductor canal. Adductor canal block with local infiltration group (ACB and infiltration group ) (group 3):having local infiltration of aneasthesia in surgical incision before dressing (The LIA consisted of 20 mg bupivacaine, 30 mg ketorolac and 0.5 mg adrenaline) with injection of levobupivacaine 0.25% ( 20 ml )After negative aspiration through the needle then drug was slowely injected in the adductor canal. Data collected for each group were, block characteristics (onset and duration of sensory block), visual analogue scale for assessment of postoperative pain, analgesic duration and analgesic consumption, haemodynamics (heart rate, mean arterial blood pressure and Spo2) and complications (nausea and vomiting). Demographic data included (age, sex, height and weight) and duration of surgery were reported. Postoperative IV fentanyl at dose of 0.5 mg/kg and to be repeated if needed/4 hours as a rescue analgesic for the patient complained of intolerable pain (VAS> 4). After data collection and analysis, this study demonstrated that both regional anesthetic techniques either ultrasound guided adductor canal block with local infiltration at surgical incision or adductor canal block alone can provide good to excellent postoperative analgesia in patients undergoing unilateral at and below knee fracture surgeries and decrease rescue analgesic consumption. However, adductor canal block with local infiltration at surgical incision is more effective with longer duration of action, more stable hemodynamics and lower analgesic consumption than adductor canal block alone.