Document resource
Application for ESRA Abstract Prizes:Background and Aims Effective postoperative pain control without motor impairment is crucial for facilitating recovery in ambulatory knee surgery. While neuraxial and peripheral nerve blocks are commonly employed, their associated motor blockade may delay early ambulation. The adductor canal block (ACB) is well-established for providing predominantly sensory blockade. The biceps femoris short head (BiFeS) block, a more recent technique, has shown promise for sensory-selective analgesia in knee arthroplasty, 1 but remains underexplored in knee arthroscopy. We present a case demonstrating the combined use of ACB and BiFeS block to provide effective postoperative analgesia while preserving motor function.Methods A 41-year-old male undergoing knee arthroscopy for meniscopathy received an ultrasound-guided ACB with 10 mL of 0.25% bupivacaine followed by a BiFeS block using 25 mL of 0.25% bupivacaine. General anesthesia was subsequently induced. No additional analgesics were administered.Results In the post-anesthesia care unit, the patient reported a Visual Analog Scale (VAS) pain score of 2/10 and demonstrated a Bromage score of 0, indicating the absence of motor blockade. Ambulation was achieved within a few hours. Postoperatively, only intravenous paracetamol (1000 mg) was administered. The patient was discharged the same day without any complications. No rescue analgesia was required, and there were no readmissions within the first 24 hours.Abstract P328 Figure 1Ultrasound image (a) and schematic illustration (b) of the BiFeS block. BS: Biceps femoris short head; BL: Biceps femoris long head; F: Femur shaft; SN: Sciatic nerve; Dashed arrow: Needle trajectoryConclusions This case demonstrates that the combination of ACB and BiFeS block—both primarily sensory techniques—can deliver effective postoperative analgesia without motor impairment, enabling early ambulation and same-day discharge after knee arthroscopy. Further studies with larger cohorts and randomized trials are warranted to confirm efficacy and reproducibility.Reference Kilicaslan A. PainMed. 2025. doi:10.1093/pm/pnaf068.