Effects Of Different Anesthesia On Early Postoperative Effects Of Total Knee Arthroplasty

Objective Nowadays,there are many ways of anesthesia had been used for TKA(total knee arthroplasty).To achieve a comprehensive comparison between single Femoral and Sciatic nerve blocking anesthesia and epidural anesthesia in total keen arthroplasty,according to the degree of postoperative pain,early functional exercise after knee arthroplasty,adverse reactions and so on.Methods Sixty patients undergoing total knee arthroplasty were randomly divided into two groups:single Femoral and Sciatic nerve blocking group(group A,n = 30),epidural anesthesia(Group B,n = 30).All patients are recorded with age(y),sex,body weight(kg)and KSS score.The following observation and detection provided comparison between the 2 group:(1)Score of visual analog scale(VAS)at the time of 6h(T1),12h(T2),24h(T3),48h(T4),72h(T5),96h(T6)at rest after surgery.(2)Score of VAS in T4,T5,T6 VAS score was maintained at 48 h(T4),72 h(T6),96 h(T6)during continuous passive movement(CPM).(3)The maximum angle of knee flexion without severe pain(VAS<7).(4)The time of angle of knee flexion reached 90°,the active leg raising straight of surgical side lift off the bed more than 10 cm,and length of stay after surgery.(5)Adverse reactions:Headache,Dizziness,Nausea,Vomiting?Puncture site pain?Uroschesis and so on.Results The postoperative VAS score of rest of group A was lower than that of group B at each time point,and the difference of T1,T2 and T3 was statistically significant(P <0.05),but there was no statistically significant difference in T4,T5 and T6(P> 0.05).The VAS pain score with movement of group A was significantly lower than that of group B at each time point(P <0.05).Postoperative angle of knee flexion in group A was higher than that in group B(P <0.05).Group A were lower than group B with the time of angle of knee flexion reached 90°,the active leg raising straight of surgical side lift off the bed more than 10 cm and length of stay after surgery and the number of uncture site pain(P <0.05);The number of cases of pain and uroschesis in the group B was more than that in group A(P <0.05),and the other adverse reactions were not significantly different.Conclusion The single Femoral and Sciatic nerve blocking anesthesia and epidural anesthesia,they could both ensure the successful completion of surgery,but single nerve blocking anesthesia can get better postoperative effect of early pain of rest and movement.This was very beneficial to the patients in early functional exercise and recovery,also can make patients get better satisfaction and reduce patient hospital stay.