Clinical Efficacy Of Transcutaneous Electrical Acupoint Stimulation In Perioperative Period Of Total Knee Arthroplasty

Background:Total knee arthroplasty(TKA)can be anesthetized by subarachnoid block-unilateral lumbar anesthesia.The advantages of this anesthesia are accurate,less impact on the inner ring and good for postoperative recovery.Continuous femoral nerve block was used to control perioperative pain in TKA patients.Femoral nerve block belongs to regional block,which has the advantages of little influence on the physiological function of the patient,low requirement for hardware equipment,simple operation,high safety and exact analgesic effect.With the widespread application of ultrasound imaging technology,the location method of femoral nerve block is more minimally invasive and accurate,and the successful rate of nerve block is also significantly improved.Because the surgical site of TKA involves femoral nerve,which is innervated by bone nerve,obturator nerve,saphenous nerve and lateral femoral cutaneous nerve,blocking femoral nerve can play a key role in analgesia,but there are still some shortcomings,such as blocking femoral nerve alone can not completely block the pain transmission around the knee joint;The high dosage may also lead to the risk of local anesthetic poisoning,and the poor control of limb swelling after operation.Transcutaneous electrical acupoint stimulation(TEAS)is an important complementary and alternative medical method that integrates traditional Chinese medicine acupuncture and moxibustion concepts and treatment methods and percutaneous nerve electrical stimulation technology.It inhibits the upload of peripheral pain stimulus signals,and promotes the release of endogenous peptide,thus playing an analgesic role.Clinical operation has the advantages of non-traumatic,simple method and high patient compliance.Local use of percutaneous electrical stimulation can effectively improve the hemorheology of patients,and play an active role in preventing the formation of deep venous thrombosis of lower limbs.Objective:To observe the sedative and analgesic effects of subarachnoid block anesthesia,ultrasound-guided continuous femoral nerve block analgesia combined with transcutaneous electrical acupoint stimulation during the perioperative period of TKA and the control of limb swelling after TKA.In order to provide more reference for further clarifying the safety and operability of the compound method.Method:Forty patients with degenerative knee joint changes requiring TKA from October 2017 to October 2018 in Hospital were selected as the study data.According to the method of random number table,40 cases were divided into control group and study group.Routine TKA was performed in control group,and TEAS was used in study group on the basis of control group.The two groups were compared and analyzed:(1)Blood pressure,heart rate and BIS during operation.(2)Operation time,VAS score,swelling of affected limbs,intraoperative bleeding volume,clinical analgesic effect of the two groups,etc.(3)The complications of the two groups were analyzed.Result:1.The BIS data,VAS scores,the onset and maintenance time of anesthesia in the study group were significantly better than those in the control group(P < 0.05),with statistical significance.2.There was no significant difference in bleeding volume and operation time between the two groups(P > 0.05).3.The levels of MAP and HR at T2,T3 and T4 nodes in the study group were significantly better than those in the control group(P < 0.05),with statistical significance.4.The incidence of limb swelling in the study group was significantly lower than that in the control group(P < 0.05).5.The IL-6 and C-reactive protein in peripheral peripheral blood had increased after operation in both groups,but the study group had a short increase time,and the corresponding difference(P<0.05),with statistically significant.6.During the perioperative period,The incidence of postoperative nausea and vomiting in patients with study group was lower than that of control group(P< 0.05).Conclusion:The perioperative TEAS treatment for TKA patients has good analgesic effect,low incidence of adverse reactions and good recovery of knee joint function.In addition,transcutaneous electrical acupoint stimulation has sedative and analgesic effects in TKA operation,and can reduce the occurrence of adverse reactions.It has certain application prospects.However,the best combination of acupoints and stimulation intensity needs to be further explored.TEAS can significantly reduce the bispectral index of patients' EEG and play a sedative role.