| Objective The purpose of this experiment is to explore the concentration of ropivacaine for relieving the pain while restore the muscle function as early as possible and getting out of bed early.Methods 90 patients who had undergone unilateral TKA were randomly divided into the group Q,the group W,the group E(n=30).The patients of the three groups were treated with different concentration of ropivacaine 20ml(the group Q,0.35%,the group W,0.375%,the group E,0.4%)for sciatic nerve block,and 0.4% ropivacaine 20 ml were performed femoral nerve block.The heart rate,blood pressure and mean arterial pressure were observed during the operation to evaluate the analgesic effect.The patient’s pain was assessed by visual analogue scale(visual,analogue,score,VAS).The ankle pump movement was used Score of hospital for special surgery(HSS score)to assess the recovery of muscle strength after the operation.Results The general data of the three groups were not statistically significant(p<0.05)Table 1.Three groups of patients in group Q,group W and group E were compared with MAP and HR and the time of admission(T0),There is no obvious difference(p>0.05).The differences of MAP and HR at each time point of T1,T2,T3 and T4 were not statistically significant(p>0.05)Table 2.21,Table2.22.Compared with the W group,the VAS scores in group Q and group E were not statistically significant in 6h,30 h,36h,42h(p > 0.05).The difference in VAS at other times was statistically significant(F=40.07~601.20,p<0.05).The difference between the Q group and the W group was statistically significant compared with the W group at each time point(p<0.05)Table3.1.W group and E group VAS scores were less than 4 points.In group Q,the pain score VAS were more than 4 points from 18 h to 30 h Figure 3.2.Intra group comparison : there were statistically significant differences before 24 h in group Q(P<0.05).The difference of muscle strength score was statistically significant before 18 h in group W(P<0.05).The difference of muscle strength score was statistically significant before 36 h in group E(P<0.05).Inter group comparison : Compared with the W group,the difference between the Q group before 24 h was statistically significant,and the difference of the muscle strength score before 36 h was statistically significant in the group E(F=10.55~394.16,P<0.05).The time of muscle strength block in group Q is shorter.The block time of group W was moderate.E group had longer muscle block time Table 4.The difference between the three groups of muscle strength recovery time was statistically significant(F=19.65~904.89,P<0.05)Table 5.Conclusion Sciatic nerve compound femoral nerve block by 0.375% ropivacaine in total knee arthroplasty is suitable for the postoperative analgesia and early exercise. |
