Clinical Observation Of Continuous Anterior Lumbar Plexus Blockade For Postoperative Pain Relief After Total Knee Replacement

Objective:To observe the effect of continuous anterior lumbar plexus block with different concentration ropivacaine on postoperative pain relief after total knee prosthesis (TKR).Methods:Forty-five ASAI-II patients undergoing unilateral TKR under general anesthesia were selected.They were randomly divided into three groups.The patients of group A received continuous intravenous fentanyl,. The patients of group B were given 0.2%ropivacaine through a nerve block catheter, and the patients of group C were given 0.15%ropivacaine through the same catheter. All patients were maintained analgesia for 50 hours. Visual analogue score (VAS) during rest and movement, muscle strength grades, sedation level and complications were recorded.Results:The VAS during rest and movement at postoperative 4 h,8 h,12 h,24 h,48 h of group B and C were all obvious lower than those in group A, P<0.05 or P<0.01. There weren't significant difference about the VAS between group B and group C Compared with group A, the incidence of side effects was significant lower in group B and C. It was satisfactory about average muscle strength degree in all groups.Conclusion:After TKR surgery, modiffied continuous anterior lumbar plexus block with 0.15%or 0.2%ropivacaine can provide adequate pain relief, slight impact on muscle strength and fewer side effects.