To Observe The Effect Of Triamcinolone Acetonide Analgesia In Total Knee Arthroplasty

Objective:To observe the effect of different doses of triamcinolone acetonide was added into cocktail to TKA postoperative analgesia effect,the mobility of the knee joint,incision healing.Materials and methods:This a prospective,randomized controlled clinical trials research,according to include/exclude standards,continuous selection 72 patients in orthopaedic trauma undergo unilateral total knee arthroplasty for osteoarthritis between December 2014 and January 2017 in Hunan provincal people's hospital.Patients were randomly assigned to group of D,E,F.The cocktail of Group D which was not add triamcinolone acetonide acetate,add 25 mg triamcinolone acetonide acetate in group E,or 50mg triamcinolone acetonide acetate in group F.Patients with preoperative record such as age,body mass index,knee joint mobility,resting visual analogue scale(RVAS),active visual analogue scale(AVAS),and other general information.Mastering all TKA,which were completed by director doctor under the hard outer hemp,cocktail was injected around the articular cavity before and after the installation in surgery.To give flurbiprofen ester 50mg Qd iv for postoperative analgesia after operation over the first three days,if patients with VAS>7 points in postoperative,an extra dizocine injection is used to remedy the pain.Patients do functional exercise under guidance of physician after surgery in two days.After the third day,under the guidance of doing knee joint function exercise activities.Recorded data respectively in patients with postoperative 48 h,1 week,2 week,4 week of knee joint motion.Recorded data respectively in patients with postoperative 6h,12h,24h,48h,72h of RAVS.Recorded data respectively in patients with postoperative 48h,72h,24h,48h,72h,1 week,2 week,4 week of AVAS.Recorded the days take out stitches postoperative and the total number patients with each additional dizocine injection,incision length and how long of surgery lasting.Results were analysing by using statistical software SPSS17.0.VAS score,joint mobility,time of take out stitches,time of surgery lasting,surgical incision length were analysed by test.They were described With(X±S),the incidence of the side effects were analysed by X~2 test.P<0.05 has been considered statistical significance.Results:Group B and group C after 48 h,1 week,2 week,4 week of knee joint motion is bigger than group C,P<0.05,that has been statistically difference.Group B after 48 h,1 week,2 week,4 week of knee joint activity compared with the corresponding time point of group C after knee joint mobility has no obvious difference,P>0.05,there was no statistically difference.Group B and group C after 6 h,12 h,24 h,48 h,72 h RVAS score results are less than that in group A,P<0.05,statistically differences.Group B after 6 h,12 h,24 h,48 h,72 h RVAS score results compared with group C,there is not the difference,P>0.05,no statistical significance.Group B and group C postoperative 48 h,72 h,1 week,2 week,3 week AVAS ratings are less than group A,P<0.05,with statistical significance.Group B postoperative 48 h,72 h,1 week,2 week,3 week AVAS score results compared with group C,there is not the difference,P>0.05,no statistical significance.Conclusion:"Cocktail"with 25 mg triamcinolone acetonide acetate can enhance the analgesic effect of postoperative in total knee arthroplasty.Increase the dose of triamcinolone acetonide acetate in"cocktail",the effect of analgesia postoperative do not increase accordingly in TKA surgery.