Efficacy Of Cocktail Therapy In Total Knee Arthroplasty

ObjectiveThrough the clinical observation of "cocktail" therapy in total knee arthroplasty(TKA),discussed the analgesic effect,joint function,adverse reaction and postoperative analgesic drug use of different "cocktail" formulations.Methods60 patients with knee osteoarthritis and unilateral total knee arthroplasty were diagnosed in my department from March 2017 to April 2018,and were randomly divided into two groups of 30 patients.Group A: bupivacaine(150mg,4branch)+ adrenaline(0.25 mg,1/4branch)+ sufentanil(50ug,1branch)+ compound betamethasone(1ml,1branch)+ flurbiprofen ester gentamycin(50mg,1branch)+(2well);Group B: bupivacaine(150mg,4branch)+ epinephrine(0.25 mg,1/4branch).Both groups had unilateral TKA,and the operation time was controlled at about 1.5 hours,and the same analgesic method was adopted after the operation.Patients with unbearable pain could be given the same analgesic treatment as amparol dihydrocodeine.Data such as basic patient statistics,were collected during hospitalization and during postoperative follow-up.Joint motion(ROM)and pain visual analogue scale(VAS)were evaluated before operation,12 hours after operation,1 days after operation,3 days after operation,5 days after operation,and 2 weeks after operation respectively.KSS was recorded 2 weeks before operation and 2 months after operation.The possible complications were recorded within 2 weeks after operation.Recorded the use of analgesics within 2 weeks.ResultsAll the 60 patients were successfully operated.There was no significant difference in sex,age,weight and average operative time between the two groups(P < 0.05).The VAS scores of the 2 groups were significantly different after 12 hours,1 day after surgery,3 days after surgery,5 days after surgery and 2 weeks after surgery.The VAS scores at 12 hours,1 day,3 days,5 days and 2 weeks after operation were significantly changed in both groups.There were significant differences in ROM scores between the two groups at 12 hours,1 day,3 d-ays and 5 days after operation(P < 0.05).There were significant differences in KSS scores between the two groups at 2 weeks after operation(P < 0.05).There was no significant difference in KSS score and ROM score between the two groups at 2 weeks and 2 months after operation(P > 0.05).There was no significant difference in the number of postoperative adverse reactions such as nausea,vomiting,venous blood stasis,poor skin healing and edema of lower extremities between the two groups within 2 weeks after operation(P > 0.05).There was significant difference in postoperative analgesic application between the two groups(P < 0.05).Conclusions:1.The formula of the study group was more helpful to relieve the pain in the early and middle stage after unilateral TKA operation,but in the middle and late stage of hospitalization,the advantage of analgesic effect was not obvious.2.In the study group,the early exercise rate of the prescription group was faster than that of the control group,but there was no significant difference between the two groups in the middle and later stage of functional exercise.3.The formula of the study group did not increase venous blood stasis,poor skin healing,lower limb edema and other adverse reactions,and no infection occurred in patients.4.The formula of the study group can effectively reduce the dosage of postoperative analgesic drugs.