November 29, 2025
Background: Effective pain management after knee surgery is critical for recovery and minimizing opioid use.
Case Presentation: We present the case of a patient undergoing open reduction and internal fixation (ORIF) for a comminuted patellar fracture and subsequent hardware removal because of persistent medial knee pain from hardware prominence. Despite initial opioid administration under general anesthesia, severe postoperative pain necessitated rescue with peripheral nerve blocks. Adductor canal, anterior femoral cutaneous, and vastus lateralis blocks provided significant pain relief without additional opioids.
Conclusion: This approach reduces systemic opioid exposure, which is particularly important in the current opioid crisis. Peripheral nerve blocks, especially the vastus lateralis block, effectively managed severe postoperative pain, highlighting their role in opioid-sparing strategies. These findings support the broader adoption of regional anesthesia to enhance perioperative outcomes while promoting early mobilization and rehabilitation.
Keywords: Opioid sparing; pain management; peripheral nerve blocks; vastus lateralis block.
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