Research recognized with a Best of Meeting Abstract Award by ASRA Pain Medicine^®

Adding two additional nerve blocks to a standard multimodal pain regimen for total knee replacement did not significantly reduce worst pain in the recovery room or total opioid use in the first 24 hours, based on a clinical trial conducted at the Hospital for Special Surgery in New York, NY. The study supports the hypothesis that, while the extra blocks may have some benefits, the standard regimen remains highly effective for most patients.

The American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine®) has recognized the work with a Best of Meeting Abstract Award at its 51st Annual Regional Anesthesiology and Acute Pain Medicine Meeting, being held April 16-18 in Phoenix, AZ.

In the study, researchers randomly assigned patients undergoing total knee arthroplasty to receive either the usual nerve block combination of adductor canal block plus infiltration between the popliteal artery and capsule of the knee (iPACK) or that same regimen plus genicular and anterior femoral cutaneous nerve blocks. All patients received standardized multimodal pain management. Investigators compared pain scores and opioid use over 7 postoperative days. Most pain and recovery measures were similar between groups. The only notable difference was statistically significant lower opioid use on the first day after surgery in patients who received the additional blocks.  The intervention group had fewer patients experienced severe pain in the recovery room (45.4% vs 54.6%, p=0.087), and the intervention group had median of 6.2 hours readiness for discharge compared to 16.2 hours in the control group (p=0.12).  However, neither of these secondary comparisons reached statistical significance. 

The investigators concluded that adding genicular and anterior femoral cutaneous blocks did not meaningfully improve early postoperative pain or overall opioid use, though there may be a modest benefit for some patients, such as ambulatory pathway patients, in reducing opioid needs on the first day. The results supported their continued use of the standard nerve block regimen for most patients while highlighting areas for future research into optimizing pain control after knee replacement.

On behalf of Principal Investigator Jiabin Liu, MD, PhD, FASA, Maya Tailor, BA, will present “Adding Genicular and Anterior Femoral Cutaneous Nerve Blocks for Knee Arthroplasty Analgesia, Randomized Double-Blinded Trial” on April 18, 2026, at 8 am during the session “Motor Preserving Blocks: How Distal Can I Go and Still Make A Clinical Difference In Analgesia.” Additional authors on the study are Juliet E. Rowe, MPH, Mia Zonies, BA, Angela Puglisi, BS, Marko Popovic, BS, Alex Illescas, MPH, David H. Kim, MD, William P. Qiao, MD, Stephanie I. Cheng, MD, DABMA, FAAMA, Enrique A. Goytizolo, MD, Christopher J. Li, MD, Douglas S. Wetmore, MD, Jonathan C. Beathe, MD, David J. Mayman, MD, Brian P. Chalmers, MD, Alejandro Gonzalez Della Valle, MD, Michael P. Ast, MD, Gwo-Chin Lee, MD, Jonathan M. Vigdorchik, MD, Danyal H. Nawabi, MD, FRCS, Miriam Sheetz, BS, Justas Lauzadis, PhD, Pa Thor, PhD.