| Objective: By using percutaneous acupoint electrical stimulation on specific acupuncture points of patients after total knee replacement,the effect on sleep quality after total knee arthroplasty was observed,and the impact on early pain control and functional recovery was discussed,which provided a reference for the selection of sleep disorder prevention and treatment after total knee replacement.Methods: From December 2021 to December 2022,a total of 80 patients who met the criteria of this study who underwent the first unilateral total knee replacement were screened and included in this clinical study,each group consisted of 40 cases,and subjects were randomly divided into an experimental group and a control group by coin tossing.Anesthesia and surgical techniques were the same for both groups of patients,in which the control group was given conventional treatment before and after surgery,and standardized functional exercise and rehabilitation training were guided.On the basis of the control group,the experimental group routinely disinfected the subjects’ local acupoints from 1day before surgery,took Shenmen,Neiguan,and Anmian,and Sanyinjiao as the main acupoint for percutaneous acupoint electrical stimulation treatment,once a day,for one week.The Pittsburgh Sleep Quality Index(PSQI)score and various influencing factors score,SAS score of the Self-Rating Anxiety Scale(SAS),postoperative VAS pain score and postoperative knee HSS function score of the two groups were observed and recorded,and the use of additional sleeping aids in the two groups during the study period was recorded.The differences between the two groups were observed and compared.Results:1.Baseline comparison: Before surgery,there was no significant difference in age,sex and surgical site between the two groups(P>0.05),and their baseline conditions were comparable.2.Total score of PSQI score: The preoperative statistical score showed that the control group(6.90±2.023)scored and the experimental group(7.05±1.632)scored,A significant difference was not found between the two groups’ preoperative PSQI scores(P>0.05).In both groups,the sleep scores improved significantly the night of surgery,with the experimental group receiving(12.18±2.854)scored and the control group receiving(12.85±3.026)scored.There was a slight difference in performance between experimental and control groups,but the difference was not statistically significant(P>0.05).The scores of both groups on the third postoperative day were lower than those on the day of surgery,the control group(10.9±2.968)scored,the experimental group(8.88±2.441)scored,It was found that the experimental group performed better than the control group(P<0.05),As compared to the third postoperative day,both groups’ scores decreased on the fifth postoperative day,the control group(8.85±2.271)scored,the experimental group(6.15±1.626)scored,The experimental group outperformed the control group by a significant margin(P<0.05).3.PSQI single sleep factor score: Neither group had a significant difference in single sleep factor on the day of surgery(P>0.05).On the third postoperative day,Statistically significant differences were observed between the experimental and control groups in terms of sleep quality factors(P<0.05),while the difference in other factors was not statistically significant.On the fifth postoperative day,the experimental group was better than the control group(P<0.05)in the comparison of four factors: sleep quality,sleep onset time,sleep disorder and daytime dysfunction,and there was no significant difference in other factors(P>0.05).4.Anxiety self-rating scale SAS: Among the subjects in this study,there was no significant difference in preoperative anxiety between the control group(48.28 ± 4.951)and the experimental group(48.33 ± 5.126)(P>0.05).On the night of surgery,Neither the control group(55.65±6.270)nor the experimental group(54.60±5.410)showed significant differences(P>0.05).On the third postoperative day,the control group(51.85±6.150)scored,and the experimental group(47.53±5.291)scored,and A better result was obtained by the experimental group versus the control group(P<0.05).On the fifth day after operation,the control group(48.05±5.625)scored and the experimental group(44.43±5.272)scored,which was significantly better than the control group(P<0.05).5.Use of additional sleeping aids: During the study period,15 patients in the control group used alprazolam tablets because of insufficient sleep,and 7 patients in the experimental group used alprazolam tablets.The difference between the two groups was statistically significant(P<0.05).6.VAS pain score: Both groups had higher VAS scores on the night of surgery,compared with the VAS scores after surgery,but there wasn’t a statistically significant difference between them(P>0.05).On the third and fifth postoperative days,the VAS score showed a downward trend,and the experimental group was better than the control group at the same time node(P<0.05).7.Knee HSS function score: comparing the postoperative HSS score of the two groups,there was no significant difference between the two groups on the second postoperative day(P>0.05),and the scores of both groups on the 3rd day after surgery and the 5th postoperative day showed an upward trend,and the comparison results of the same time node showed that the HSS function score of the experimental group was better than that of the control group(P<0.05).8.Safety observation: During the study period,there were no serious adverse reactions and complications in both groups.Only one patient in the experimental group experienced dizziness during TEAS treatment,which was relieved after lowering the current intensity of TEAS,and agreed to continue treatment after consultation with the patient.Conclusion: Percutaneous electrical stimulation can improve postoperative PSQI score and SAS score,improve postoperative sleep quality and postoperative anxiety,so as to reduce the use of additional drugs after surgery,and effectively prevent and treat sleep disorders after knee replacement.It can also reduce the patient’s pain score and accelerate the recovery of knee function after surgery. |
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