Pain Efficacy Of Preemptive Analgesia And Multimodal Analgesia In Total Knee Joint Replacement Surgery

Background:By comparing different time periods after comparing different solutions VAS pain scores,discuss ahead and multimodal analgesia combined analgesic efficacy and postoperative knee function artificial knee arthroplasty(TKA) recovery after treatment.Methods:Second Hospital of Shanxi Medical University, collected in January 2014 to August due to osteoarthritis underwent unilateral total knee replacement surgery in patients with a total of 120 cases, according to the different pain patients were divided into four groups program, A was the control group( preoperative and intraoperative and postoperative analgesia was no corresponding application controlled intravenous analgesia(PCIA)), Research group B for preemptive analgesia group( preoperative oral celecoxib + postoperative intravenous analgesia pump(PCIA)), group C cocktail analgesia group( injected around the intraoperative and postoperative intravenous cocktail joint controlled analgesia(PCIA)), D group for multi-modal analgesic combination( preoperative oral celecoxib + surgery + articular injection of a cocktail around the Bank of postoperative controlled intravenous analgesia(PCIA)). Record four groups of patients in the postoperative 6h, 12 h, 24 h, 48 h, 72 h and under load resting VAS score; TKA surgery after extubation, 72 h, 1 week, 2 weeks, 3 weeks of joint activity; perioperative complications occurrence.Results:(1) Four groups of patients after TKA knee motion(ROM) of t-test, range of motion in groups B, C and D groups were superior when extubation group A, p<0.05, with statistically significant. Group B and Group C after extubation, three days, one week, two weeks and compare three weeks, P>0.05, not statistically significant; D group of motion and 72 h after extubation were is better than B, C group, and in one week, two weeks, three weeks and three groups, P>O.05, was not statistically significant.(2) In the resting state postoperative VAS score four groups of patients using the t test, four groups of patients with VAS pain score with time and gradually becomes smaller. After four groups of patients were compared, group B, C,D group after each stage of VAS scores were lower than in group A, p <0.05, statistically significant; group B and group C, the two groups had no significant differences in scores,p>0.05, not statistically significant; D postoperative VAS scores at each time was less than the other three groups, scores P<0.05, statistically significant.(3) In the active state after four groups of patients to be VAS scores and the results were t test, where group B, C, D group VAS scores were lower than in group A, p<0.05, statistically significant; group B, and group C, no significant difference between the two groups, P>0.05, not statistically significant; the patients in group D scores at each time point were less than group B, group C, P<0.05, the difference was statistically significant.(4) occurs by chi-square test for the four groups of patients after 2 weeks after perioperative complication rate, P>0.05, the difference was not statistically significant; none of the four groups of patients after surgery to form a double deep venous thrombosis, wound necrosis infection does not appear.(5) of the four groups of patients with postoperative KSS score display, group B, C, D group were better than in group A,p<0.05, statistically significant; group B C KSS score between groups was no significant difference, P>0.05, not statistically significant; D group KSS scores than group B and group C,P<0.05, significant difference.Conclution:The study shows that preemptive analgesia preoperative, intraoperative local injection pain, postoperative controlled intravenous analgesia pump joint satisfaction, adverse reactions did not increase, and the operation is simple and safe.