Motor-sparing regional anaesthesia for total knee arthroplasty: a narrative and systematic literature review

Br J Anaesth. 2025 Jan 2:S0007-0912(24)00704-9. doi: 10.1016/j.bja.2024.10.041. Online ahead of print.

Abstract

Total knee arthroplasty is a life-changing surgical procedure that is associated with a high incidence of severe postoperative pain. Key to enhancing recovery after surgery is effective analgesia and early mobilisation. Innovations in motor-sparing regional anaesthesia techniques that have improved recovery include targeted surgical local infiltration analgesia, adductor canal blockade, genicular nerve blocks, and the infiltration between the popliteal artery and posterior capsule of the knee (iPACK) block. This narrative review discusses the current available motor-sparing regional anaesthetic techniques and assesses the evidence supporting each.

Keywords: adductor canal block; analgesia; nerve block; regional anaesthesia; total knee arthroplasty.

Publication types

  • Review