Clinical Research Of Continuous Femoral Nerve Block For Analgesia And Early Functional Rehabilitation After Total Knee Arthroplasty

ObjectivesTo observe and discuss method and value of analgesia and the significance of early knee joint function recovey after total knee Arthroplasty (TKA)MethodsAll cases come from the inpatient department from July 2015 to March 2016 of Guangdong Hospital of TCM. According to the inclusion and exclusion criteria, to entry of 44 cases of primary total knee Arthroplasty. These patients are randomly divided into two groups.22 cases of experimental group are be chosen to continuous femoral nerve block after surgery, while the other 22 cases of matched group are not.Analgesic solution:the experimental group patients are given celecoxib 200 mg bid Po with 48 hours preoperative. To make local blockade around joints before Sew leather and to continuous femoral nerve block after surgery which is instead of celecoxib 200 mg bid po after 72 hours. The matched group patients are given celecoxib 200 mg bid Po with 48 hours preoperative. To make local blockade around joints before Sew leather and to use Dynastat 40mg ql2h iv which is instead of celecoxib 200 mg bid po after 72 hours.To finish the outcome of the data collection according to the analgesia effect, knee joint, knee joint mobility score, overall satisfaction, remedial analgesic drug, adverse reactions to evaluate. To examining the differences of related indicators to comparing the advantages and disadvantages of two kinds of analgesic solution by analyzing all the data via SPSS18.0.ResultCompare two groups of analgesia, All the pain score while resting and activiting were lower in the continuous femoral nerve block group. The pain score in the experimental group after 6 h,12 h, day 1 to 3 days were lower than the matched group, which has statistical significance (P＜0.05). All the knee joint active and passive activity were higher in the continuous femoral nerve block group. The knee joint activity on day 1 to 4 days,6 days to 7 days were higher than the matched group, which has statistical significance(P＜0.05). The knee joint passive activity on day 1, day 2,6 days,7 days were higher than the matched group, which has statistical significance(P＜0.05).The HSS score after 1 week was higher in the experimental group than the matched group, which has statistical significance(P＜0.05). Overall satisfaction of two groups of patients discharged, remedial analgesia drug utilization rate, incidence of adverse reactions are no significant correlation, which has no statistical significance (P＞0.05).ConclusionAll the pain score while resting and activiting in the experimental group were lower than the matched group. All the knee joint active and passive activity were higher than the matched group. The HSS score after 1 week was higher in the experimental group than the matched group. We may safely draw the conclusion that With continuous femoral nerve block is a center of multimodal analgesia scheme for analgesia after total knee arthroplasty, and patients early knee joint function rehabilitation has a positive effect.