Outpatient continuous adductor canal block (CACB) for total knee arthroplasty: a double-blinded randomized placebo-controlled trial
Bibliographic record
Abstract
BACKGROUND: Total knee arthroplasty (TKA) is a widely performed procedure, with postoperative pain presenting as a major barrier to early mobilization and patient satisfaction. While single-injection adductor canal blocks (SACB) offer effective short-term analgesia, their limited duration often leads to rebound pain. Continuous adductor canal blocks (CACB) extend analgesic effects but are underexplored in outpatient settings. The objective of this study is to assess whether CACB improves quality of recovery and analgesia, in comparison to SACB in an outpatient or short-stay setting for TKA patients. METHODS: Double-blind randomized controlled trial comparing the Quality of Recovery-15 (QoR-15) score on postoperative day (POD) 2 (primary outcome) and opioid consumption, pain scores, hospital length-of-stay, and complications (secondary outcomes), between patients receiving CACB and SACB, when undergoing primary TKA. RESULTS: 60 patients were enrolled and randomized to two treatment groups: CACB (30) and SACB (30). Patients in the CACB group had significantly higher QoR-15 scores at PODs 1 (128.83±12.36 vs 109.00±15.90, p<0.001), 2 (131.27±10.23 vs 110.86±15.37, p<0.001) and 3 (131.97±13.94 vs 111.18±18.28, p<0.001). They also had lower opioid consumption and pain scores at rest and with movement during the first three PODs. No major complications or signs of local anesthetic systemic toxicity were observed. CONCLUSIONS: In our study, CACB significantly enhanced early postoperative recovery and analgesia following TKA in an outpatient or short-stay setting, compared with SACB, and these results support its broader adoption in fast-track TKA pathways.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".