The Application Of Tourniquet Pain Test In Identifying Potential Over Pain After Total Knee Arthroplasty

Objective:According to the clinical diagnosis of knee osteoarthritis(Knee Osteo,Arthritis,KOA)before and after underwent total knee arthroplasty for tourniquet pain test,patients with different pain thresholds for total knee arthroplasty(Total Kee,Arthroplasty,TKA)preoperative and postoperative VAS score,KSS knee blurred vision(Keen Society Score)score,Karnofsky score(Karnofsky,KPS)relationship.Through experimental study,we can identify the possible pain of patients with low pain threshold before undergoing total knee arthroplasty,and provide individualized analgesia program and operation mode for patients with severe VAS.Method : From January 2016 to January 2017,in the orthopedic department of the First Affiliated Hospital of Xinjiang Medical University,a clinical diagnosis of osteoarthritis of the knee is clear,48 patients underwent total knee arthroplasty patients;all patients were Kellgren and Lawrence grading of knee osteoarthritis grade 3 or above.The full assessor can tolerate TKA surgery.All patients had no surgical taboos to improve hemoglobin,platelet,coagulation function,electrocardiogram,cardiac ultrasound and lung function before operation.Continuous epidural anesthesia was performed.All patients' TKA operations were performed under the supervision of the same doctor in the same hospital,and the same prosthesis was used.All TKA were performed under the same type of anesthesia(nerve block).After TKA,all patients used the same method to prevent venous thrombosis,pain management,and physical therapy.Postoperative pain management including injection,intra-articular cocktail analgesic mixture during operation hours using COX-2 inhibitor drugs after 72.The tourniquet with a standard sleeve width was tied to the forearm near the elbow 5cm,and the tourniquet was inflated to 250 mmHg as a standard pain stimulus.The VAS score of the subjects at 3min(30s)was recorded.If the subjects were not tolerated before the prediction time,it was VAS100 mm.The VAS scores and theWOMAC and KSS scores of the subjects were recorded and preserved.The WOMAC and KSS scores were measured before and 1,3 and 6 months after the follow-up.After the data collection was completed,3 groups were divided into mild(0-44mm),moderate(45-74mm),and severe(>74mm)according to the preoperative VAS score.The KSS,WOMAC scores and relationship of three groups of patients with mild to moderate and severe postoperatively were compared.The SPSS20.0 software package was used for statistical analysis.The data data are represented by mean standard deviation.The analysis of variance was compared between the measured data,and the difference between P<0.05 was statistically significant.Result:Total knee arthroplasty,severe VAS patients WOMAC score and KSS score were lower in VAS patients with mild and moderate.Total knee arthroplasty after severe VAS patients WOMAC score and KSS score improvement compared with the VAS group of patients with mild and moderate.Conclusion:The purpose of total knee replacement is to enable the patient to regain a painless,stable,and functional new joint.Persistent postoperative pain is an unacceptable and important complication for both the patient and the operator.Doctors in Department of orthopedics need to fully evaluate the pain sensitivity of patients.Preoperative comprehensive evaluation of patients,reasonable operation during operation,and correct postoperative rehabilitation exercise after operation can effectively reduce the incidence of pain after total knee arthroplasty.