Combined adductor canal (ACB) and sacral erector spinae plane (S‑ESP) blocks for total knee arthroplasty pain in hemophilic arthropathy.

We present the case of a successful application of combined adductor canal block (ACB) and sacral erector spinae plane (S‑ESP) block for the management of a patient suffering from severe hemophilia A with an end‑stage arthropathy who underwent total knee replacement. The implementation of a tailored protocol, not incorporating neuraxial techniques, such as spinal anesthesia, facilitated optimal intra‑ and postoperative pain management and expedited postoperative recovery and rehab without motor weakness and side effects, highlighting the potential benefit of such strategy in selected cases. [ABSTRACT FROM AUTHOR]