Analgesic Effect Of Popliteal Plexus Block Combined With Adductor Canal Block After Total Knee Arthroplasty

Objective:To observe the effect of Popliteal plexus block combined with Adductor canal block for patients after Total knee arthroplasty.Methods:Sixty patients who underwent unilateral total knee arthroplasty were selected,15 males and 45 females,age<80 years,BMI18-30 kg/m~2,ASA physical status I-III.Patients were divided into PPB combined with ACB group(group P)and ACB group(group A),30 patients in each group.ACB was performed with 15 ml of 0.5%ropivacaine and PPB was performed with20 ml of 0.5%ropivacaine in Group P before anestheic induction.And only ACB with 0.5%ropivacaine 15 ml performed in Group A.Record the dosage of remifentanil and the time of operation.And the pain VAS score of posterior knee、rest and dynamic were recorded at 4,8,24,48,72 hours after surgery.The maximum range of knee motion was recorded on day 1,2,3after operation.The motion block of the affected side limb was observed at 4,8 and 24 hours after surgery.Recorded the total compression times and effective compression times of analgesic pump and requirements for rescue analgesia.The first time of patient out of bed,postoperative hospital stay,satisfaction score of patients after operation and adverse events were recorded.Results:1.Compared with group A,the total amount of remifentanil in group P was significantly reduced(P<0.05).2.The patients in group P posterior knee pain VAS score at 4 and 8 hours after operation was lower than group A(P<0.05).The patients in group P rest pain VAS score at 4,8,24,48,and 72 hours was significantly lower than group A.The patients in group P dynamic pain VAS score at 4 and 8 hours after operation was lower than group A(P<0.05).3.The range of motion of the knee from 1 to 2 day was significantly increased(P<0.05).4.the rescue analgesia times,the total compression times and effective compression times of analgesic pump in group P were significantly lower than those in group A(P<0.05).5.Compare with group P,the days of hospitalization and Patient satisfaction was significantly improved(P<0.05).Conclusions:Popliteal plexus block combined with Adductor canal block provide improved the analgesic effect for TKA patients without affecting the motor function,conducive to early ambulation of patients,improved the hospital stay,patient satisfaction,and promoted early recovery of patients.