Clinical Efficacy Analysis Of Adductor Canal Block And Femoral Nerve Block In Enhanced Recovery After Total Knee Arthroplasty

Objective To compare the clinical effects of adductor canal block and femoral nerve block in multi-mode analgesia with enhanced recovery in total knee arthroplasty.Methods A total of 100 patients with primary knee osteoarthritis diagnosed in our hospital and given surgical treatment from January 2018 to January 2019 were collected and counted.The patients were divided into two groups by random number table method: adductor canal block(ACB)group and femoral nerve block(FNB)group,with 50 cases in each group.Two groups of patients received advanced analgesia(clinical education + oral administration of celecoxib at 200mg/ day)2 days before surgery.Before lumbar anesthesia,patients in the two groups were given ACB and FNB analgesia respectively.After surgery,automatic analgesia pump was connected and intermittent knee ice compress was given.The Visual Analogue Scale/Score(VAS)of the patients in the two groups before and after surgery(4h,12 h,24h,48 h,72h,1w)was observed.Range of motion of the knee;Quadriceps muscle strength;Patient satisfaction and other conditions were statistically analyzed.Adverse events such as lower extremity thrombosis and catheter infection within 1 week after surgery,as well as falls,were recorded.Results There was no statistically significant difference in preoperative general data and observation indexes between ACB and FNB groups(P > 0.05).The VAS score of the ACB group was better than that of the femoral nerve block group two days after operation(P< 0.05).There was no significant difference between the two groups between 3 days and 1week after surgery(P > 0.05).ACB and FNB two groups of patients with postoperative muscular tube block within three days of knee joint mobility group is superior to the femoral nerve block group(P < 0.05);There was no significant difference between the two groups one week after surgery(P > 0.05).The muscle strength of quadriceps femoris in the adductor duct block group was significantly better than that in the femoral nerve block group(P < 0.05).The patient satisfaction results of the two groups showed that 50 patients(100%)in the ACB group were satisfied,while 49 patients(98%)in the FNB group were satisfied.According to the statistical method,Fisher’s exact test was adopted,and the result showed that P=1,indicating that there was no statistically significant difference in patient satisfaction between ACB and FNB groups(P >0.05).There was no significant difference in nausea and vomiting between the two groups after surgery(P > 0.05).No adverse conditions such as lower limb venous thrombosis and catheter infection occurred in the two groups within 1w after surgery.One patient in the FNB group fell.Conclusion ACB and FNB are equally safe under the guidance of the concept of rapid recovery and multi-mode combined analgesia.In terms of pain control,ACB has better analgesic effect than FNB in the early stage.ACB has less impact on quadriceps femoris muscle strength,which makes the recovery of knee joint function faster,and is conducive to early postoperative functional exercise and postoperative rehabilitation of patients.ACB is more suitable for rapid rehabilitation and clinical promotion.