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A retrospective comparative provider workload analysis for femoral nerve and adductor canal catheters following knee arthroplasty.

Rasmussen M, Kim E, Kim TE, Howard SK, Mudumbai S, Giori NJ, Woolson S, Ganaway T, Mariano ER. A retrospective comparative provider workload analysis for femoral nerve and adductor canal catheters following knee arthroplasty. Journal of anesthesia. 2015 Apr 1; 29(2):303-7.

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Adductor canal catheters preserve quadriceps strength better than femoral nerve catheters and may facilitate postoperative ambulation following total knee arthroplasty. However, the effect of this newer technique on provider workload, if any, is unknown. We conducted a retrospective provider workload analysis comparing these two catheter techniques; all other aspects of the clinical pathway remained the same. The primary outcome was number of interventions recorded per patient postoperatively. Secondary outcomes included infusion duration, ambulation distance, opioid consumption, and hospital length of stay. Adductor canal patients required a median (10-90th percentiles) of 0.0 (0.0-2.6) interventions compared to 1.0 (0.3-3.0) interventions for femoral patients (p  <  0.001); 18/23 adductor canal patients (78 %) compared to 2/22 femoral patients (9 %) required no interventions (p  <  0.001). Adductor canal catheter infusions lasted 2.0 (1.4-2.0) days compared to 1.5 (1.0-2.7) days in the femoral group (p  =  0.016). Adductor canal patients ambulated further [mean (SD)] than femoral patients on postoperative day 1 [24.5 (21.7) vs. 11.9 (14.6) meters, respectively; p  =  0.030] and day 2 [44.9 (26.3) vs. 22.0 (22.2) meters, respectively; p  =  0.003]. Postoperative opioid consumption and length of stay were similar between groups. We conclude that adductor canal catheters offer both patient and provider benefits when compared to femoral nerve catheters.

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