Effects Of Infiltration Anesthesia In The Posterior Capsule Space Of The Knee On Analgesia And Movement After Total Knee Arthroplasty

Objective: To compare the effect of adductor canal block combined with infiltration between the popliteal artery and capsule of the knee with distal adductor canal block on analgesia and activity after total knee arthroplasty.Methods: Sixty patients undergoing unilateral total knee arthroplasty in our hospital from June 2019 to September 2019 were included.They were randomly selected and randomly divided into group P and group A with 30 cases in each group.After general anesthesia,group P was under ultrasound-guided adductor canal block and infiltration between the popliteal artery and capsule of the knee,while group A was under ultrasound-guided distal adductor canal block.After the operation,the resting pain NRS score of the two groups of patients was recorded in the post-anesthesia recovery room(PACU)and 4h,8h,12 h,24h and 48 h after the operation.NRS scores for exercise pain at 4h,12 h,and 24 h after surgery.the number of analgesia pump compressions within 48 h,and the number of remedial analgesia.The movement of leg lifting,plantar flexion,and dorsiflexion at 4h after operation,and the active joint curvature at 6h and 24 h after surgery was recorded.The assisted walking distance on postoperative day 2(POD 2)and postoperative day 3(POD 3)after operation was recorded and also post-nausea,vomiting,dizziness,falls and other adverse events.Results: Compared with group A,group P had lower NRS scores for resting pain at 4h,8h,12 h,and 24 h after surgery(P <0.05);and scores for exercise pain were lower at 4h,12 h,and 24 h after surgery(P<0.05).In comparison of the number of analgesia pump compressions within 48 hours after surgery in both groups,the number of compressions in group P was significantly lower than that in group A(P <0.05).At 6h and 24 h after surgery,the active joint flexion of the two groups of patients in comparison,the active joint curvature of patients in group P was significantly improved compared with patients in group A(P <0.05).Conclusion: Adductor canal block combined with infiltration between the popliteal artery and capsule of the knee can significantly reduce patients' resting pain and exercise pain after total knee arthroplasty,reduce the use of postoperative analgesics,and increase joint curvature.