Comparative evaluation of ultrasound-guided adductor canal block using levobupivacaine with or without fentanyl for postoperative analgesia in arthroscopic knee surgery: A randomized controlled trial: Levobupivacaine with fentanyl in ACB

Introduction: Postoperative pain following knee surgery is often severe and may delay rehabilitation. This study evaluated the safety and efficacy of adding fentanyl to levobupivacaine in ultrasound guided adductor canal block (ACB). Methods: One hundred patients scheduled for arthroscopic knee surgery were randomly assigned to two groups: Group L received 20 ml of 0.25% levobupivacane, while Group FL: who received Fentanyl (1µg/kg) with 0.25% levobupivacaine to a total volume of 20 ml. Postoperative analgesia, rescue analgesic requirement, patient satisfaction, hemodynamic stability, and complications were recorded. Results: Group FL demonstrated significantly lower VAS pain scores and reduced rescue analgesic use compared to Group L. Patients in Group FL reported higher satisfaction with pain management and showed greater hemodynamic stability. Mild adverse effects, including nausea, vomiting, hypotension, and tachycardia, reported in both the groups. Conclusion: The addition of fentanyl to levobupivacaine in ultrasound guided adductor canal block enhances postoperative analgesia, improves hemodynamic stability, increases patient satisfaction, and reduces analgesic requirements without increasing adverse effects in knee surgery patients.