To Compare With The Effectiveness Of Two Methods On The Analgesia After Total Knee Arthroplasty

Objective:To compare the analgesic efficacy of single shot injection of femoral plus sciatic nerve block(A group) with periarticular cocktail drug injection analgesia(B group) after total knee replacement and evaluate the knee function after followed-up study postoperatively.Inorder to find an effective analgesial method.Methods: From September 2013 to August 2014, 50 patients undergoing unilateral knee arthroplasty were randomized into two groups,25 cases each.All of the patients were measured undering ASAⅠ~Ⅱ. Single shot injection of femoral plus sciatic nerve block(A group) was given for postoperative analgesia and periarticular cocktail drug injection analgesia(B group) for another way. All patients received spinal anesthesia combined with epidural anesthesia.During the postoperative period, Visual analogue scale(VAS) was used to evaluate the postoperative pain scores.Observing and recording:total amount of lornoxicam, COX inhibitor,muscle strength of lower limbs and analgesia associated complications. All patients were followed up for two weeks,one month,three months,six months,using Lysholm system to evaluate knees’ functions. Results:In 4h、6h、12h、24h、36h、48h postoperative period, pain scores(VAS) of A group was significantly lower than B group(P<0.05).During the continuous passive movement(CPM) of knee postoperatively at 24 and 48 hours,the total amount of using cumulative lornoxicam of A group was lower than that of B group(P<0.05). Adverse clinical syptoms: pruritus, nausea and vomiting and so on were no significant difference(P>0.05). No significant difference was found in knee function evaluation of two groups after two weeks,one month,three months,six months followed-up(P>0.05).Conclusion:Single shot injection of femoral plus sciatic nerve block is not only an effective method in managing postoperation pain after TKA,but also worth popularizing.