Effects Of Multimodal Analgesia On Postoperative Anxiety And Depression In Patients With Knee Arthroplasty

Objective: Patients with osteoarthritis who receive knee arthroplasty are prone to complications such as chronic pain,anxiety and depression.There is an extremely important and complex relationship between pain and emotional state.The main purpose of this study is to explore whether multimode analgesia can reduce postoperative pain,reduce postoperative anxiety and depression,and improve the quality of life of patients after knee arthroplasty.Methods: Fifty-nine patients undergoing elective knee arthroplasty were divided into experimental group(n = 29)and control group(n = 30).The experimental group was given multimode analgesia(oral celecoxib 3 days before operation,iliac fascial space block guided by ultrasound before induction of general anesthesia,intra-articular injection before installation of prosthesis,routine intravenous pump,oral celecoxib 3 days after operation)intervention.The control group was given postoperative analgesia with routine intravenous pump.Pain scale(VAS),lower limb functional status scale(AKS)and anxiety and depression scale(HAD)were scored before operation,on the 3rd day,7th day and 3 months after operation.Statistical methods were used to describe and analyze the data of the two groups,and evaluate the anxiety and depression,analgesic effect and functional recovery of lower limbs in the intervention group and the control group.Results: There were significant differences in HAD scores between the two groups on the3 rd day after operation(anxiety:t=3.25,P<0.01;depression:t=5.08,P<0.01)and 7 days after operation(anxiety:t=2.59,P<0.05;depression:t=2.66,P<0.05).It was proved that multimodal analgesia could improve patients' depression and anxiety in a short time.The scores of VAS in the multimode analgesia group were lower than those in the control group on the 3rd day(t=7.85,P<0.01),7th day(t=5.17,P<0.01)and 3 months(t=2.10,P<0.05)after operation.The VAS scores in the exercise group were significantly lower than those in the control group on the 3rd(t=5.76,P<0.01)and 7th day(t=4.12,P<0.01)after operation,but there was no significant difference between the two groups 3 months after operation(t=1.83,P>0.05),indicating that multimodal analgesia can effectively relieve perioperative pain.The AKS scores of patients in the multimode analgesia group were higher than those in the control group on the 3rd day(t=3.23,P<0.01),7th day(t=7.05P<0.01)and three months(t=2.81,P<0.05)after operation,suggesting that multimode analgesia can improve the recovery of patients,and the hospitalization time in the multimode analgesia group was shorter than that in the control group(t=7.33,P<0.01).Conclusion: Multimodal analgesia can reduce postoperative anxiety and depression in a short time,relieve perioperative pain,improve postoperative recovery and shorten hospital stay.