Short Term Effect Of "Cocktail" Therapy On Unilateral TKA Analgesia

Objective:The clinical data of 60 patients with unilateral total knee arthroplasty were analyzed by grouping.The analgesic efficacy of local injection of "Cocktail Mixture" in the articular cavity of TKA was compared,which provided a reference for postoperative pain relief and rapid recovery of TKA patients.method:To collect and analyze the data of patients who underwent unilateral knee arthroplasty at the China-Japanese Union Hospital from January 2016 to December 2017.Sixty patients included in the study group were divided into three groups of 20 patients each.Three groups The patients were performed by the same surgical team.The first group was given morphine 5mg,ropivacaine 150 mg,compound beclomethasone 1ml,epinephrine 0.25 ml to 100 ml and the local injection into the joint cavity.The second group received ropivacaine 150 mg,Compound beclomethasone 1ml,saline mixed to 100 ml,local injection,the third group as a blank control intraoperative articular injection of saline 100 ml,three groups of patients were 60 ml injection in the posterior joint capsule and the joint space,the remaining 40 ml Note medial and lateral collateral ligament,patellar ligament,patella support band,joint capsule and other places.The patients in all three groups were given routine analgesic therapy and rehabilitation functional exercise after TKA.The pain scores and functional recovery of the patients were evaluated by statisticing the VAS and HSS scores and the straight leg raising time in different time periods.In this study,the data were analyzed by SPSS 22.0 software.The results of age,weight,operation time,VAS score,knee HSS score,patients active straight leg raising time and so on were in accordance with the normal distribution.Standard deviation (?)±s,said three groups of data using one-way analysis of variance test(ANOVA),two groups compared with independent samples T test,different results at P <0.05 was considered statistically significant.Result:1.patient basic informationThree groups of patients in terms of age,weight,gender,operation time and other basic information differences were not statistically significant(P> 0.05).2.Visual acuity scores within 72 hours after surgery in 3 groups(VAS score).Within 72 hours after operation,the VAS score of the first group and the second group in resting state and active state were lower than that in the third group(P <0.05);after 72 hours,the first group(P> 0.05),while the VAS score of the second group had no statistical difference compared with the third group(P> 0.05),while the VAS scores of the first group and the second group in the second group were statistically significant compared with the third group.3.Postoperative 72 h three groups of patients with knee HSS scoreThe HSS scores of the three groups at 72 h after operation were statistically different(P <0.05).4.The HSS score of knee joint in 3 groups after 1 weekThe HSS scores of the three groups were statistically significant(P <0.05)5.VAS score of knee joint in three groups after 1 weekThere was no significant difference in resting VAS scores among the three groups(P> 0.05),but there was a statistically significant difference(P <0.05).6.patient active straight leg raising timeThree groups of patients with active straight leg raising time statistically significant difference(P <0.05)7.Postoperative adverse reactions in three groups of patients comparedNo potoperative three groups of patients with redness,rash and other adverse reactions,the first group of patients with postoperative nausea,vomiting and other adverse reactions was 10℅,the second group of 3 cases 15℅,the third group of 25℅,No statistical difference(P> 0.05)Conclusion:1.Joint cavity injection of cocktail mixture of analgesic method has the advantages of simple operation,the effect is obvious and does not increase the number of adverse reactions and many other advantages,while patients with controlled intravenous analgesic drug use can reduce the nausea,vomiting,drowsiness and other adverse reactions The incidence of TKA is a very good analgesic.2."Cocktail" therapy is more and more widely used in the analgesic mode of total knee arthroplasty.Due to the diversity of its matching programs,its application standard has not been unified.Reference to clinical studies,in the "cocktail" injection of analgesics can be used central analgesics(morphine),local anesthetic(ropivacaine),glucocorticoid(beclomethasone),epinephrine and other drugs mixed application method,It is reported in the literature,but also may join tranexamic acid,antibiotics and other drugs.3.Cocktail analgesia is effective in early analgesia.To relieve long-term and chronic pain,a multi-mode analgesic scheme should be combined to relieve the postoperative pain of patients,and provide more protection for better rehabilitation.