Analgesic Effectiveness And Safety Research Of Glucocorticoid In Total Knee Arthroplasty

Background: TKA postoperative analgesic taken periarticular injection mixing the drug(often referred to as a cocktail)Combined multimodal analgesia showed good postoperative pain relief and improve range of motion(ROM)and reduce postoperative complications.However,the dose and drug cocktail ingredient no gold standard.Studies have shown that the drug cocktail included topical steroids may reduce inflammation after surgical trauma reactions,thereby reducing pain.But many surgeons do not recommend the use of steroids,as patients bear the incision healing,the risk of infection,complications such as rupture of the patellar tendon.Objective: To investigate the TKA postoperative analgesia cocktail recipes to add small doses of glucocorticoids to improve postoperative pain efficacy and safety.Reference selection cocktail recipes in drug combinations and doses infiltration analgesic action for clinicians performing total knee replacement surgery in patients with peripheral joints.Methods: 40 patients were randomly divided into control and experimental groups.Test group 75 ml saline mixture containing 150 mg ropivacaine,adrenaline 0.1mg,dexamethasone 5mg,control group without dexamethasone.Unified anesthesia program.Former patellar incision through the vastus medialis medial approach cut the joint capsule.After completing the osteotomy,pre-installation of the prosthesis full knee flexion,the surgeon physician will inject 30 m L cocktail behind the joint capsule.After prosthesis implantation in the incision,deep soft tissue,periosteum uniform injection of the remaining 45 m L.Patients with surgeons,patients,patient participate in the evaluation of postoperative pain doctors are unaware of group assignment.Results: The two groups were 6,12,24,48 h after surgery,no significant difference in pain scores.One patient test group has cut the central skin necrosis,an area of about 1* 4cm size,removal of necrotic skin suture two weeks after suture removal,wound healing.Two groups in wound complications,no significant difference(P> 0.05)three days after the incidence of nausea and vomiting.Conclusion: This study shows that the test dose dexamethasone added cocktail recipes not increase the incidence of postoperative infection and other complications,but compared to the group without addition of dexamethasone can play to improve the acute phase of pain after total knee action.Add cocktail recipes in small doses of corticosteroids does not improve postoperative nausea and vomiting.