Comparison Study of Adductor Canal Block with 0. 25% and 0.5% Bupivacaine for Postoperative Analgesia in Outpatient Arthroscopic ACL Repair

Introduction: Effective postoperative pain management is critical for enhancing recovery and patient satisfaction after anterior cruciate ligament (ACL) reconstruction surgery. Traditional femoral nerve blocks, while effective, can cause quadriceps weakness, delaying mobility. Adductor canal block (ACB) has emerged as an alternative, providing adequate analgesia while preserving quadriceps strength. This study aimed to compare the analgesic efficacy and safety of 0.25% versus 0.5% bupivacaine administered via ACB in outpatient arthroscopic ACL repair. Materials and Methods: This prospective study, conducted at Mamata Medical College, included 60 patients (ASA I or II, aged 18–50) undergoing outpatient arthroscopic ACL repair. Patients were randomized into two groups: Group A (0.25% bupivacaine) and Group B (0.5% bupivacaine), each receiving 20 mL via ultrasound-guided ACB. Postoperative pain was assessed using the Visual Analog Scale (VAS) at multiple intervals up to 24 hours. Secondary outcomes included time to first analgesic request, total analgesic consumption, motor recovery, and complications. Statistical analysis was performed using SPSS v25, with p < 0.05 considered significant. Results: Group B showed significantly longer analgesia duration (11.1 ± 4.2 vs. 8.4 ± 2.6 hours, p = 0.024) and lower total analgesic use (7.5 ± 3.1 mg vs. 12.3 ± 4.6 mg, p = 0.001). VAS scores were consistently lower in Group B across all time points, with significant differences observed from 6 to 24 hours. Motor recovery was similar in both groups, and complications were mild and comparable. Conclusion: The use of 0.5% bupivacaine provides superior analgesia with prolonged pain relief and reduced opioid consumption compared to 0.25% bupivacaine in outpatient ACL repair, without compromising safety.