Clinical Efficacy Study Of "Cocktail" Therapy Combined With Intravenous Analgesia Pump After Total Knee Arthroplasty

Objective:To explore the clinical effect of "cocktail" therapy combined with intravenous analgesia pump on reducing early pain after TKA,promoting postoperative joint function recovery and reducing postoperative blood loss.Methods:Patients who were admitted to our hospital from May 2019 to November 2020 and planned to undergo the first unilateral TKA were randomly divided into three groups according to different dosage regimen,with 20 patients in each group.Group A was injected with the "cocktail" of drugs for analgesia around the joint during TKA operation,and the Patient Controlled Intravenous Analgesia(PCIA)was applied for analgesia after operation.Group B was only treated with the Patient Controlled Intravenous Analgesia after operation.Group C was only injected with a "cocktail" of drugs around the joint during the operation.Visual analogue score(VAS)was used to evaluate the situation of knee pain in different postoperative states in the three groups,and the postoperative the effect of recovery,HSS knee score,the number of adverse reactions,and the number of remedial opioid use cases within 24 hours were compared.Blood loss(including total blood loss,hidden blood loss,intraoperative blood loss,the Hb and HCT decreased values at 3 days after surgery,and blood transfusion rat,etc.)was recorded in the three groups.Results:1.In the VAS scores of patients with resting pain at 6h,12 h,24h,48 h and 72 h after surgery,the score of group A was observably lower than that of group B and C,with statistical significance(P<0.05).2.In the VAS scores of patients with active pain at 6h,12 h,24h,48 h and 72 h after surgery,the three groups all reached the peak of active pain at about 48 h after surgery,and the VAS scores of patients in group A were significantly lower than those in group B and C,with statistical significance(P<0.05).3.In comparison of the results of maximum flexion of knee joint activity 24 h,48h and 72 h after surgery,group A was makedly higher than the other two groups,with statistical significance(P<0.05).4.According to the results of HSS knee joint score,in the HSS knee joint function score of patients on the 7th,14 th,and 30 th days after surgery,the knee joint function score of group A was memorably higher than that of group B and C,with statistical significance(P<0.05).5.Comparison of the time taken for patients to achieve the straight leg-raising after surgery showed that the time needed for group A to achieve the straight legraising after surgery was shorter than that of group B and group C,with significant difference and statistical significance(P<0.05).6.In the use of the remedial opioid(dizocine 10mg)intravenously within 24 hours after surgery,the number of patients in group A using the remedial opioid was significantly lower than that in group B and C,the number of patients in group B was the largest,and there was A prominent difference between group A and group B and C,with statistical significance(P<0.05).7.The total blood loss,hidden blood loss and the Hb and HCT decreased values at 3 days after surgery in group A and C were all less than those in group B,with statistical significance(P<0.05).There was no noteworthy difference in the intraoperative blood loss and blood transfusion rate among the three groups(P>0.05).8.The results of the initial postoperative lying in bed activity time of patients showed that the initial activity time of patients in group A was earlier than that in group B and C,and there was A significant difference between the two groups,with statistical significance(P<0.05).9.Among the adverse reactions,only one case of dizziness and no other obvious adverse reactions occurred in group A,and the total probability of adverse reaction symptoms was 5%;In group B,there was a patient with malignant vomiting and a patient with dizziness,and the total probability of adverse reactions was 10%.A patient in group C had pruritus,and the total probability of adverse symptoms was5%.Therefore,there was no conspicuous difference in adverse reaction results among groups A,B and C(P>0.05),that is,there was no increase in the risk of adverse reaction in group A compared with group B and C.Conclusion:"Cocktail" therapy combined with intravenous analgesia pump without any increase in adverse reactions,and can effectively relieve the TKA early postoperative pain and improve the range of motion(ROM)of joints,can effectively reduce postoperative blood loss at the same time,promote patients early joint functional exercise,which is beneficial to early postoperative knee function recovery,is a safe and effective treatment.