| Background:Total knee arthroplasty (TKA) has become the effective treatment for patients with end-stage knee disease. However,90% of the patients experienced severe pain after TKA. Although several studies have shown that both of the multimodal analgesia and patient controlled analgesia can effectively reduce perioperative pain levels of total knee arthroplasty, comparative researches about the efficacy and safety of these two methods were rarely reported.Objective:To compare the efficacy and safety of multimodal analgesia versus patient controlled analgesia in TKA.Methods:From February 2013 to March 2014,60 consecutive patients treated with unilateral primary TKA from a single surgeon were enrolled and randomly divided into two groups. In multimodal analgesia (MDA) group (n= 27), paticipants had an intra-articular and surrounding tissue injection of cocktail intraoperatively, and opioids and non-steroidal anti-inflammatory drugs postoperatively. In patient controlled analgesia (PCA) group (n=33), paticipants only received PCA postoperatively.Numerical rating scale (NRS) was used to measure pain severityevery 4 hours within 72 hours after surgery. NRS was recorded at 1,2,3 weeks postoperatively as well. Patient satisfaction was recorded at postoperative week 1, week 2 and week 3. Joint functional rehabilitation rate was recorded at postoperative day 1, day 2 and day 3. Patient’s analgesic consumption and complications were recorded. The independent t-test test was used to compare measurement data, the chi-squared test was used to compare count data, and the rank sum test was used to compare level information A probability of< 0.05 was considered statistically significant.Results:(1) NRS at different postoperative time were significantly lower in MDA group than in PCA group (p<0.05); (2) Patient’s satisfaction was significantly higher in MDA group than in PCA group (p<0.05) at postoperative week 1, week 2 and week 3; (3) Patient’s analgesic consumption and complications were significantly lower in MDA group than in PCA group at postoperative week 3 (p<0.01); (4) Joint functional rehabilitation rate was significantly higher in MDA group than in PCA group at postoperative day 1 (p<0.01).Conclusion:MDA compared to traditional PCA utilized in primary unilateral TKA could significantly decrease perioperative pian level, reduce patient’s analgesic consumption and complications and promote joint functional rehabilitation. |
