The Effect Of Cocktail Therapy Combined With Epidural Single Low Dose Morphine On Postoperative Analgesia Of TKA

Objective: To study the effect of cocktail therapy combined with epidural single low dose morphine on pain control after total knee arthroplasty(TKA).Methods: A randomized,double-blind,controlled study was conducted on 160 patients with knee osteoarthritis who were treated with unilateral TKA in our hospital from February 2018 to September 2018 for the first time.Epidural anesthesia was used in all cases.They were randomly divided into four groups,40 patients in each group: group A was given cocktail therapy(hormone-containing)combined with epidural single low dose morphine;group B was given cocktail therapy(hormone-free)combined with epidural single low dose morphine;group C was given simple cocktail therapy(hormone-containing);group D was given simple cocktail therapy(hormone-free).Visual analogue score(VAS)of patients at rest state for 2,6,12,24,48 and 72 h and at active state for 24,48 and 72 h after operation in four groups,maximum flexion range of motion of knee joint at 2nd,3rd,4th and 5th day after operation,and postoperative adverse reactions were recorded.Results: There were significant differences in VAS score and knee joint activity among the four groups(F=10.798,P<0.001;F=6.220,P=0.001;F=6.075,P=0.001).The VAS scores in groups A,B and C at rest and active state were significantly lower,and the range of motion of knee joint in groups A,B and C was significantly greater than those in group D(P<0.05 for all).The average VAS score in group C at rest was significantly higher than in group A,with a difference of 0.52(P=0.005).Conclusion: Cocktail therapy combined with epidural single low dose morphine showed stronger and more synergistic analgesic effect after TKA,which could better improve the knee joint functional activity after TKA.Under the conditions of no hormone contraindication and adverse reactions,it was suggested that glucocorticoid should be added to “cocktail” mixed analgesics.