| Background: In current clinical practice,there is no consensus on the composition,ratio and injection method of cocktail therapy,as well as no uniform appraisal standard for efficiency.Many clinical studies on cocktail therapy mainly focuses on postoperative analgesia,thus less involved in other indicators such as postoperative knee function recovery therefore appraisal is not systematic enough.Objective: To comprehensively evaluate the efficacy of cocktail therapy on postoperative pain control and functional recovery in total knee arthroplasty(TKA),and provide a reference for clinical practice.Methods: Through the test of efficacy analysis,the estimated sample size was 50 cases per group.From August 2017 to August 2018,patients undergoing initial unilateral total knee arthroplasty surgery at Dalian university affiliated Zhongshan Hospital’s Department of Orthopedics,according to the specific screening criteria,100 cases were selected and randomized by the block.The length of the fixed group was twice that of the study group,and a total of 6 blocks were generated.A string of 1-6 random numbers was generated using SPSS22.0 software.The blocks were arranged in numerical order and divided into test group and control group.50 cases in each group except that the patients in the experimental group were added with cocktail therapy while all the other treatment methods were the same.All the patients’ anesthesia and surgery were performed by the same group of doctors,and the cocktail therapy was completed by the same doctor.The static and dynamic pain visual analogue scales(VAS)at 6h,12 h,24h,48 h,72h,4d,7d,and 14 d after operation were compared between the two groups.The patient’s self-controlled analgesia was performed within 48 hours after operation.Thenumber of compressions of Patient Controlled Intravenous Analgesia(PCIA),the amount of remedial analgesic drugs used within 14 days after surgery,the active and passive maximum mobility of knee joints at 24 h,48h,72 h,4d,7d,14 d after surgery,7d,14 d after surgery The knee joint score of the 30-day knee for the Hospital for Special Surgery(HSS)and the occurrence of adverse reactions.Results: All 100 patients completed the trial without exit.The static VAS scores of the experimental group at 0h,12 h,24h,48 h,and 72 h were 0,(0,0±0.49),(1.24±0.71),(0.96±0.75),and(1.12±0.71),respectively.The VAS scores were(0.64±0.66),(1.96±0.63),(2.22±0.76),(2.30±0.81),and(2.72±0.63),which were significantly lower than the control group(P<0.05).The number of PCIA compressions in the experimental group was(12.52±7.81)within 48 hours after operation,which was significantly lower than that in the control group(P<0.05).The amount of remedial analgesic drugs used in the experimental group was(5.63±3.32)mg within 14 days after surgery.Significantly lower than the control group(P<0.05);The active activities of the knee joints in the experimental group were(58.56±4.52)degrees,(67.55±7.43)degrees,(80.58±5.87)degrees,(86.45±7.75)at 24 h,48h,72 h,4d,7d and 14 d.Degree,(92.32±3.75)degrees,(101.73±5.82)degrees,passive maximum activity are(64.34±4.99)degrees,(79.55±5.35)degrees,(90.35±6.82)degrees,(99.21±7.21)degrees,(106.56±4.77)and(110.25±3.89)degrees were all greater than the control group(P<0.05).The HSS knee scores of the experimental group were(62.89±6.35)and(74.56±4.98)at 7 and 14 days after operation.The scores were higher than those in the control group(P<0.05).There was no significant difference between the two groups in the static and dynamic VAS scores at 4 days,7 days,and 14 days after surgery,and the HSS knee scores and postoperative adverse reactions at 30 days after surgery.P>0.05).Conclusion: This study adjusted the formula,dosage and use of cocktails to observe a number of postoperative evaluation indexes.It was found that cocktail therapy can effectively control the early pain after total knee arthroplasty,which can significantly reduce the use of postoperative opioids dosage as well as promote safe and early recovery of knee function. |
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