The Clinical Effect Of Electroacupuncture On Analgesia In Total Knee Arthroplasty

Purpose:To observe the effect of electroacupuncture therapy on total knee arthroplasty(TKA)perioperative analgesia.To understand the effect of electricity on levels of serum prostaglandin E2,beta-endorphin levels,and to further predict its analgesic mechanism.To confirm the safety and efficacy of electroacupuncture in postoperative analgesia after total knee arthroplasty,and provide clinical evidence and laboratory data for the application of acupuncture therapy in postoperative analgesic therapy.Methods:Selection of guangzhou university of Chinese medicine treated in the hospital during the period of 2017.05 to 2018.02,40 cases of severe knee osteoarthritis patients into two groups according to random number table method,through 1-40 digital envelopes randomly assigned after TKA surgery,will be equipped with the number 1-set to electric acupuncture group of 20 patients with 20(electric acupuncture combined with multimodal analgesia),equipped with digital 21 to 40 patients is set to the control group(simple)multimodal analgesia.In both groups,epidural anesthesia was used in both groups.After surgery,two groups of patients were treated with routine epidural analgesia and oral celecoxib pain,and the electroacupuncture group assisted acupuncture analgesia.The whole acupuncture operation of acupuncture group was performed by the same physician using the same brand acupuncture needle,electroacupuncture instrument and selecting the same set of acupuncture points.Acupoints selection is one side Liang Qiu(ST34),blood(SP),Yin ling springs(SP9),foot three mile(ST36),hong leong(ST40)and destroyed cave 40(GB),1-1.2 inches,the needles are inserted after connection electric acupuncture needling therapy apparatus(SDZ-type II),the density wave,the frequency for 2/100 hz,strength with patient tolerance advisable,treatment time for 30 minutes,acupuncture therapy for postoperative day 1 to 7 days,needle 1 times a day.Both groups took the same postoperative rehabilitation function.Records of patients with postoperative resting,active visual analog pain score(visual analogue scale,VAS),postoperative knee joint active and passive activity(range of motiong,ROM),use of painkillers,and other complications.Extraction in patients with postoperative day 1 acupuncture needle group and postoperative 7 days before a blood sample after acupuncture,the control group to extract postoperative days 1,7 blood samples,detection of two groups of patients with serum concentrations of prostaglandin E2 and beta-endorphin.All experimental data and clinical data were operated by the same doctor.Experimental data and clinical data are recorded by the same doctor,result adopt SPSS22.0 statistical software for data analysis,the experimental data with X + S,measurement data using t test,before and after treatment compared with paired t test,comparison between groups using independent sample t-test,count data and rank with chi-square test.Results:There was no significant difference between the preoperative acupuncture group and the control group age,gender,pre-acupuncture resting and active state VAS pain score,and the difference in the activity degree of the knee(P BBB 0 0.05).In the third day after the operation and the 7th day after the operation,the VAS pain score was significantly lower than that in the control group(P<0.05).The VAS pain score was significantly lower in the 3,5 and 7 days after operation than the control group(P<0.05).There was significant difference between the serum prostagnin E2 and beta-endorphin levels before and after treatment in the electroacupuncture group(P<0.05).There was no significant difference between acupuncture group and control in improving the activity of knee joint(P<0.05).In the postoperative adverse reactions,the electroacupuncture group experienced dizziness and headache,nausea and vomiting,etc.,and the use of additional pain medication was lower than that of the control group.Conclusion:1.Electroacupuncture can significantly reduce the early postoperative pain of TKA.There was no significant difference in improving the activity of knee joint.2.Electroacupuncture can reduce the incidence of postoperative complications of TKA and the use of painkillers.3.Electric acupuncture applied to TKA postoperative analgesia,through randomized study of its effectiveness,safety and before and after treatment serum content of prostaglandin E2,beta-endorphin,confirm will use in TKA postoperative analgesia is a safe and effective treatment.