Study Of Multimodal Analgesia Scheme After Total Knee Arthroplasty

Objective:This topic through two sets of PCIA centered programme in early postoperative TKA multimodal analgesia effects and comparison of knee joint function, sleep duration, and so on, looking for a simple, safe, effective and economic pain relief programmes, provides a feasible reference for postoperative pain control programs after TKA.Methods:Select March 2014 to September 2014 by Shandong TCM University subsidiary hospital joint orthopedic hard waist joint anesthesia downward single side full knee replacement patients for research object, will meet cases into standard of 65 cases patients random points experiment group and control group, experiment group: TKA operation Hou gives PCIA analgesic to drug 48 h, hydrochloride Bucinnazine 40 mg Ql2h IV 2D, nimesulide Bid Po 7d, better Le set Qn Po 2D; Control group: PCIA analgesia TKA 48 h nimesulide Bid Po 7d. Were observed in patients with early postoperative TKA VAS pain score, resting and exercise State knee mobility, sleep duration, incidence of adverse reactions, evaluation group programme for safety and effectiveness.Results:1.The experimental group patients after 12 h, 24 h and 36 h when resting VAS score significantly lower than the control group(P < 0.05), postoperative 60 h, 48 h, 72 h, 5 d, 7 d experimental VAS score no big difference with the control(P > 0.05); 2.The experimental group, 12 h, 24 h after surgery, 36 h, 48 h activity VAS score significantly lower than the control group(P < 0.05), the experimental group 6 h, 72 h after surgery, 5 d, 7 d activities VAS score below according to the group, but no big difference(P > 0.05); 3. The experimental group in TKA 2 d, 3 d motion of articular genu postoperative were significantly better than that of control group(P < 0.05), the experimental group in postoperative 4 d, 5 d, 6 d, 7 d knee motion is better than that of control group, but no big difference(P > 0.05); 4.The experimental group in postoperative 1 d and 2 d, 3 d when sleep time is better than the control group(P < 0.05), the experimental group in postoperative 4 d, 5 d, 6 d, 7 d compared with the control group, the sleep time has no obvious difference(P > 0.05); 5.Within 48 h, two groups of patients with postoperative nausea and vomiting, urinary retention, itchy skin, such as no difference between the incidence of adverse conditions.Conclusion:Dominated by PCIA, combined with nimesulide and pain, assisted by Jia Le programme of multimodal analgesia, analgesia in postoperative TKA can significantly reduce limb pain, promote early functional training exercise. Because of its easy operation, safe, effective, economical and practical advantages and does not increase the operational difficulty of bilateral postoperative analgesia in TKA, worthy of further study and application in clinical practice.