| Objective:By adopting different methods of analgesia for patients after artificial total knee replacement,explore the analgesic effect of percutaneous electrical acupoint stimulation combined with femoral nerve block on postoperative patients,and evaluate its analgesic effect,which is an enrichment of clinical analgesic measures and Multi-modal analgesia provides ideas.Methods:Eighty patients who met the criteria were selected,and the same surgeon performed the artificial total knee arthroplasty in the same way.According to the random number table method,they were divided into 4 groups with 20 cases in each group.Group A:conventional analgesia measures were taken after operation;Group B:conventional analgesia+FNB;Group C:conventional analgesia+TEAS;Group D:conventional analgesia+FNB+TEAS.Record the VAS under resting and functional exercise,HSS,knee joint swelling degree,knee joint range of motion on the second,third,fifth,and seventh days after surgery.Record the use of additional analgesics for the patient within 7 days after surgery and adverse reactions.Collect and sort out the data,use SPSS21.0 statistical software for statistical analysis,the difference is statistically significant when P<0.05.Results:A total of 80 patients were enrolled in this clinical trial,divided into 4 groups with 20 people in each group.There were no significant differences in gender,age,BMI,surgical site,preoperative resting and functional exercise status,VAS,preoperative swelling of the affected limb,and preoperative active range of motion of the knee joint(P>0.05),and they were comparable.VAS:(1)Resting state VAS:on the second postoperative day,group A has the highest VAS,followed by groups B and C,and group D is the lowest.There is no significant difference in VAS between group B and group C(P>0.05),the difference between the remaining groups was statistically significant(P<0.05).On the 3rd day after operation,the VAS in groups A and B were higher than those in groups C and D.The VAS in group C was higher than that in group D.There was no significant difference in VAS between groups A and B(P>0.05).The difference between the groups was statistically significant(P<0.05).There was no statistically significant difference in VAS between groups A and B on the 5th and 7th day after surgery(P>0.05);the scores of groups A and B were higher than those of groups C and D,and the differences between groups were statistically significant(P<0.05);There was no significant difference in VAS between the C and D groups(P>0.05).(2)Functional exercise status VAS:On the second day after surgery,group A had the highest VAS,followed by group B,followed by group C,and group D was the lowest.The difference between the groups was statistically significant(P<0.05).There was no significant difference in VAS between groups A and B on the 3rd,5th,and 7th day after operation(P>0.05).The scores of A and B groups were higher than those of C and D groups,and the difference between groups was statistically significant.(P<0.05),there was no significant difference in VAS scores between the C and D groups(P>0.05).HSS:There was no significant difference between the 4 groups of patients on the second day after surgery(P>0.05).On the third day after operation,group A had the lowest HSS,followed by group B,and group C,and group D had the lowest score.The difference between the groups was statistically significant(P<0.05).On the 5th and 7th day after operation,there was no significant difference in HSS between groups A and B(P>0.05).The HSS of groups A and B were lower than those of groups C and D,and the difference between groups was statistically significant(P<0.05).There was no significant difference in HSS between C and D groups(P>0.05).Range of motion:Group A had the lowest on the second and third day after operation,followed by group B,followed by group C,and group D had the highest.The difference between the groups was statistically significant(P<0.05).There was no significant difference between groups A and B on the 5th and 7th day after operation(P>0.05).The Range of motion in groups A and B were lower than those in groups C and D,and the difference between groups was statistically significant(P<0.05).There was no statistically significant difference between the group A,B and group C,D(P>0.05).Swelling degree:(1)10cm above the midpoint of patella:There was no statistically significant difference between the groups on the second day after surgery(P>0.05).On the 3rd,5th,and 7th day after operation,the 10 cm above the midpoint of patella in groups A and B were larger than those in groups C and D,the difference between groups was statistically significant(P<0.05).There was no significant difference between the group A,B and group C,D(P>0.05).(2)10cm below the midpoint of patella:There was no statistically significant difference between the groups on the second day after operation(P>0.05).The circumference of the 10 cm below the midpoint of patella in groups A and B were larger than those in groups C and D,the difference between groups was statistically significant(P<0.05).There was no significant difference between the group A,B and group C,D(P>0.05).Use of additional analgesic drugs: the number of additional analgesic drugs used in group A is 5(25%),group B is 3(30%),group C is 4(20%),group D is2(10%),there is no difference statistical significance(P>0.05).Adverse reactions:the number of nausea and vomiting was 6(30%)in group A,4(20%)in group B,3(15%)in group C,and 2(10%)in group D.The difference was not statistically significant(P>0.05).1 patient in each of groups C and D had skin erythema.Conclusion:Femoral nerve block and transcutaneous acupoint electrical stimulation can alleviate postoperative pain of artificial total knee joint,but the combination of the two can enhance the analgesic effect,and can relieve the swelling of the affected limb,promote joint function recovery and reduce adverse reactions.Combined femoral nerve block also has a very definite effect,which is conducive to postoperative rehabilitation,and is worthy of promotion in clinical use. |
PDF Full Text Request