EFFICACY OF BILATERAL ADDUCTOR CANAL CATHETER FOR PAIN MANAGEMENT IN POST-TOTAL KNEE REPLACEMENT SURGERY WITH HISTORY OF LUMBAR STABILIZATION: A CASE REPORT

Postoperative pain following total knee replacement (TKR) remains a major barrier to early mobilization and optimal rehabilitation. Neuraxial anesthesia techniques such as epidural or spinal blocks are effective for analgesia but may be contraindicated in patients with prior lumbar spine surgery. This case report presents a 65-year-old female with bilateral gonarthrosis and a history of lumbar stabilization (L3-L5) who underwent bilateral TKR. Postoperative analgesia was managed using bilateral continuous adductor canal block (ACB) catheters under ultrasound guidance, supplemented by multimodal systemic analgesia. Pain scores remained low (NRS 0-1), knee range of motion improved from 0-80° to 0-100° within three days, and no motor weakness or complications were observed. The results support that bilateral continuous ACB is a safe and effective analgesic strategy for TKR in patients with contraindications to neuraxial techniques, facilitating early mobilization and rehabilitation consistent with Enhanced Recovery After Surgery (ERAS) protocols.