الفهرس 
Classification of PainOnly 14 pages are availabe for public view
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Abstract
Total knee arthroplasty (TKA) is a common surgery that is associated with moderate to severe pain. Early ambulation and physical therapy are essential for functional recovery and long-term functional outcome after TKA as well as for reducing the immobility related complications. Hence optimal pain relief while maintaining the motor function remains the mainstay in postoperative pain management after TKA Analgesia after TKA can be achieved by integrated multimodal analgesic protocols using two or more analgesic modalities that work by different mechanisms that will optimize the analgesia and minimize the potential risks and side effects. In addition to the preemptive analgesia such as NSAIDs, analgesia after knee surgery can be provided by multiple nonsystemic methods such as local anesthetic infiltration and peripheral nerve block, which is commonly used to relieve postoperative pain and decrease opioid requirement and its adverse effects. Femoral nerve block (FNB) is commonly used in TKA to control postoperative pain. However, as the FNB is invariably associated with reduced quadriceps muscle strength, increased risk for fall is estimated to be 2% Consequently, with the FNB, the goal of pain relief will compromise the goal of preserving the muscle strength. The ideal nerve block for TKA should provide effective analgesia while preserving the muscle power to expedite the recovery. The introduction of ultrasonography and its use in different nerve blocks was the key of inventing the adductor canal block ACB), which is relatively new block with high success rate. In contrast to FNB, ACB is predominantly a sensory block that preserves the quadriceps muscle strength with the favorable earlier mobilization than the FNB. ACB blocks the main sensory contributions from the femoral nerve to the knee namely the saphenous nerve and the nerve to vastus medialis while they pass through the adductor canal.