EP070 Continuous adductor canal block for bilateral total knee arthroplasty: a retrospective study

<h3>Background and Aims</h3> Total knee arthroplasty is the most common orthopedic surgery in the lower extremity performed in North America. The recovery after bilateral total knee arthroplasty (BTKA) is challenging, given the need for effective pain control, early mobilization, and safe discharge home. The aim of this study is to assess the effectiveness and safety of the bilateral continuous adductor canal block (B-CACB) and compare it to the bilateral single adductor block (B-SACB) technique in BTKA. <h3>Methods</h3> Retrospective study including patients scheduled for BTKA from 2020–2023. Research Ethics Board approval was obtained (23–0223-C). Demographics, anesthesia technique, opioids consumed (OME=oral morphine equivalent), complications, and mobilization assessment were registered. Data were summarized using mean (standard deviation,SD) or median [interquartile range,IQR] for continuous variables, and frequency (%) for categorical. The measurements were compared using t-test , Mann-Whitney test , Kruskal-Wallis test or ANOVA depending on data distribution. Fisher exact test, logistic regression to assess association between variables were used. All analyses were performed STATA 14.0 (StataCorp, USA). <h3>Results</h3> Sixty-three patients were identified(table 1). There was no association between opioid consumption between 0–24 hours and the type of block(p=0.05). At 24–48 hours, the B-CACB group consumed an average of 20 mg/day less (p=0.04, 95% confidence interval:1.2–38.9 mg) of OME than B-SACB group (table 2). The B-CACB group was 3.5 times more likely to mobilize above 2 meters than B-SACB group in POD1 (OR:95% confidence interval=1.2–9.9) and 4.5 times in POD2 (OR:95% confidence interval=1.2–16.3,table 3). No patients reported LAST symptoms, three patients described leaking or dislodgement. <h3>Conclusions</h3> B-CACB is associated with lower opioid requirements at 48 hours than SACB, with a higher likelihood of reaching mobilization criteria for discharge. No adverse events were reported. B-CACB is a feasible, effective, and safe plan for BTKA surgery in a selected population, helping to decrease the burden of two surgeries in one surgical event.