Objectives: Evaluation of ultrasound-guided (USG) adductor canal block (ACB) or femoral nerve block (FNB) for enhanced recovery in arthroscopic anterior cruciate ligament (ACL) repair. The role of those blocks in enhanced recovery after arthroscopic (ACL) repair is assessed by the length of the patient's hospital stay as primary objective. The analgesic efficacy was assessed by visual analog scale (VAS), time for the postoperative first analgesic requirement, total opioid consumption, post-operative hemodynamics, and incidence of complications as secondary objective.

Background: USG ACB and USG FNB are getting more consideration for enhanced recovery in arthroscopic ACL repair.

Methods: A prospective randomized double-blind study was conducted on eighty adult patients assigned into two equal groups scheduled for elective arthroscopic ACL repair under spinal anesthesia. Group A: received USG ACB with bupivacaine 0.125% in total volume of 20 ml. Group B: received USG FNB with bupivacaine 0.125 in total volume of 20 ml.

Results: Hospital stay was significantly lower in group A than in group B. VAS score was lower in group A than in group B. Time to first analgesic request was significantly prolonged in group A than in group B. Total morphine consumption was significantly lower in group A than in group B.

Conclusion: USG ACB provides better post-operative enhanced recovery as shown by a lower hospital stay and superior post-operative analgesic effects via lower VAS score, time for the postoperative first analgesic requirement, total opioid consumption, patients' vital parameters in first 24h post-operative than USG FNB in arthroscopic ACL repair.