• Ritwik Kejriwal, Jeremy Cooper, Andrew Legg, Jeremy Stanley, Michael P Rosenfeldt, and Stewart J Walsh.
• Taranaki Base Hospital, New Plymouth, New Zealand.
• Orthop J Sports Med. 2018 Oct 1; 6 (10): 2325967118800948.

BackgroundFor reconstruction of the anterior cruciate ligament (ACL) with hamstring autograft, perioperative analgesia can be achieved with multimodal analgesia and intra-articular local anesthesia infiltration with or without additional regional blocks. Saphenous nerve block (SNB) via the adductor canal is commonly used in our practice, but its benefit has not been well established in the literature.PurposeTo assess the efficacy of SNB in ACL reconstruction with hamstring autograft.Study DesignRandomized controlled trial; Level of evidence, 1.MethodsConsecutive patients undergoing arthroscopic ACL reconstruction with hamstring autograft were randomized into a control group (no SNB) and an intervention group (SNB). All patients received standardized anesthetic induction and maintenance agents with perioperative analgesia, per study protocol, with local anesthetic infiltration of the graft harvest site and intra-articular infiltration.ResultsSixty patients were randomized into the 2 groups (n = 30 each). There was no statistically significant difference in total opiate consumption between the groups (control, 34 mg; SNB, 31 mg; P = .40). There was no statistically significant difference in visual analog scale scores for pain at 0, 8, and 24 hours postsurgery, and no difference in overall satisfaction score. The control group had a significantly higher visual analog scale score at 4 hours postsurgery (3.0 vs 1.9, P = .04).ConclusionSNB has a minimal effect on postsurgical care for ACL reconstruction with hamstring autograft in the presence of multimodal analgesia and local anesthetic infiltration.

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