Evaluation Of Four Multimodal Analgesia Strategies For Total Knee Arthroplasty

Objective:To compare the curative effect of different analgesia after knee replacement plan.Methods:Choose80patients who received unilateral total knee arthroplasty from September2011to March2013, which were randomly divided into4groups,20cases in each group. Group A:postoperative continuous femoral nerve block (CFNB)+intraoperative around jointsinfiltration analgesia (LIA)+continuous ice therapy (CCT) analgesia; Group B: postoperativeCFNB+LIA; Group C: postoperative CFNB+CCTS; Group D: postoperative grant onlyCFNB. Four groups of surgical methods and postoperative patients with other processing thesame. Observe four groups of patients with postoperative pain VAS resting state, patientsatisfaction scores, knee joint mobility and the occurrence of adverse reactions, postoperativeknee joint HSS score and related safety indicators, using statistical analysis, evaluation of fourgroups of analgesic efficacy and safety of differences.Results:Postoperative6,12,24and48h, resting VAS score A and B group were lower than C, Dgroup (P <0.05), lower than that of group D group C (P <0.05), postoperative72h, fourgroups of resting VAS score no statistical difference (P>0.05); Postoperative24,48,72h, A,B group of activities VAS scores were lower than C, D group (P <0.05), lower than that ofgroup D group C (P <0.05). The quadriceps muscle and postoperative each limb musclestrength level no statistical difference (P>0.05); After2~5D, group A and group B weregreater than active mobility group C, D group (P <0.05), group C than group D (P <0.05),6~7D after four groups have no statistical difference (P>0.05); After2~4D, A, B group ofpassive activity is greater than the C, D group (P <0.05), group C than group D (P <0.05),5~7D after four groups of passive activity no statistical difference (P>0.05); After thedifference between A and B group were not significant; There was no statistically significantdifference after four groups of adverse events (P>0.05).Conclusion:Continuous femoral nerve block joint local infiltration analgesia analgesic effect is good, can effectively relieve pain after surgery, improve the knee joint mobility, reduce the incidenceof postoperative adverse reaction, improve the hospitalized patients’ satisfaction, at the sametime will not increase the risk of opioid usage and knee joint infection, curative effect, clinicalworth extending.