{
  "abstract": "Application for ESRA Abstract Prizes:Background and Aims Total knee arthroplasty (TKA) is a common major orthopaedic surgery associated with significant postoperative pain. PROcedure SPEcific Postoperative Pain ManagemenT (PROSPECT) Working Group recommend a single shot adductor canal block (ACB) combined with peri-articular local infiltration analgesia (LIA), and that intrathecal morphine be used only where both ACB and LIA are not possible. A recent audit in our institution showed suboptimal compliance with this, with 26.5% of patients receiving ACB and LIA, and 84% of overall patients receiving LIA. Educational interventions included anaesthesia departmental teaching and a mandatory regional course for anaesthesia trainees. Following this our primary aim was to assess the proportion of patients undergoing TKA who received both ACB and LIA. Secondary points included mode of anaesthesia, use of intra-thecal morphine, other peripheral nerve blocks and dose of dexamethasone.Methods We conducted a retrospective chart analysis of TKAs performed in March 2025. Of the 69 cases in this period, 5 records were unavailable and not included. Anonymised data collected looked at mode of anaesthesia and analgesia administered.Results 28 patients (43.8%) received both ACB and LIA. 89.1% received LIA. Overall, 61 patients (95.3%) received intrathecal morphine. Of those who received both ACB and LIA, 27 (96.4%) also received intrathecal morphine. Secondary results are shown in figure 1.Abstract P331 Table 1Results of the auditConclusions Our re-audit has shown a 17.3% improvement in compliance with PROSPECT guidelines for the combined use of ACB and LIA for TKA, from 26.5% to 43.8%. It has also shown a modest improvement in the overall rate of LIA from 86.7% to 89.1%.",
  "authors": [
    {
      "affiliations": [
        "Anaesthetic Department, National Orthopaedic Hosptial Cappagh, Dublin, Ireland"
      ],
      "name": "Launcelot McGrath McGrath"
    },
    {
      "affiliations": [
        "Anaesthetic Department, National Orthopaedic Hosptial Cappagh, Dublin, Ireland"
      ],
      "name": "Róisín Ní Dhomhnaill"
    },
    {
      "affiliations": [
        "Anaesthetic Department, National Orthopaedic Hosptial Cappagh, Dublin, Ireland"
      ],
      "name": "Frances Fallon"
    },
    {
      "affiliations": [
        "Anaesthetic Department, National Orthopaedic Hosptial Cappagh, Dublin, Ireland"
      ],
      "name": "Mark Hoey"
    },
    {
      "affiliations": [
        "Anaesthetic Department, National Orthopaedic Hosptial Cappagh, Dublin, Ireland"
      ],
      "name": "Enda Shanahan"
    }
  ],
  "title": "P331 An audit of regional analgesia techniques in total knee arthroplasty at the national orthopaedic hospital, Ireland",
  "uid": "d8c98288-d781-53ec-82a6-e2b8ddc68346"
}