Contrastive Analysis Of The Efficacy Of Different Analgesic Methods After Total Knee Arthroplasty

Objective:To study the efficacy of intraoperative periarticular multimodalanalgesic drugs injection combined with postoperative single-shot femoral nerveblockade after total knee arthroplasty,then to observe whether it can be helpful for earlypostoperative functional exercise and rehabilitation.Methods:42patients undergoing unilateral TKA were randomly divided into twogroups,21patients of the study group received intraoperative periarticular injection ofmultimodal drugs (consisting of ropivacaine,morphine,epinephrine andmethylprednisolone） combined with postoperative single-shot femoral nerve blockadeof ropivacaine,and21patients of the control group received the same intraoperativeinjection of multimodal drugs and used the same doses of normal saline forpostoperative single-shot femoral nerve blockade.Breakthrough pain relief was achievedwith patients-on-demand analgesia for48h after surgery.The visual analog scores forpain at rest and during activity,range of motion, movement blockade，the consumptionof patient-controlled analgesia and adverse reaction were also recorded at differenttime-points.Results:①The study group had lower postoperative visual analog scores for painat resting time-points of2h,4h,6h,10h,12h,24h,48h and at moving time-points of24h,48h(P<0.05).At preoperation and at postoperative time-points of3d,7d,10d,14d,there was no statistical difference in the visual analog scores between twogroups(P>0.05).②The study group had greater postoperative range of motion attime-points of1h,2h,3h,7h(P<0.05).At preoperation and at postoperative time-points of10d,14d, there was no statistical difference in the range of motion between twogroups(P>0.05).③Compared to the control group,the patients of the study group usedsignificantly less postoperative patients-on-demand analgesia drugs consumption(P<0.05).④there was no statistical difference in movement blockade andadverse reaction between two groups(P>0.05)Conclusion Intraoperative periarticular multimodal analgesic drugs injectioncombined with postoperative single-shot femoral nerve blockade in total kneearthroplasty can significantly relieve the postoperative pain of patients,reduceconsumption of patient-controlled analgesia and improve range of motion at early timeafter surgery without any movement block, and then help to promote early functionalexercise and postoperative rehabilitation.