Clinical Observation Of Individualized Multimodal Analgesia In Perioperative Period Of Total Knee Arthroplasty

Objective: To observe the analgesic effect of individualized multimodal analgesia in perioperative period of total knee arthroplasty.Method: 67 patients aiming for unilateral total knee arthroplasty were selected. all the patients were administrated analgesic therapies as follows: 1 tablet of Oxycodone and Acetaminophen tablet orally 8h before TKA,local infiltration analgesia of peri-articular cavity intra-operation, ice compressed and patient controlled intravenous analgesia( PCIA) as well as oral Oxycodone and Acetaminophen table(1 table, tid) starting from 8h post-TKA。Patients were categorized into 3 groups according to the type of postoperative pain: persistent pain(I), spastic pain(II) and neuropathic pain(III). Patients were given oral etoricoxib(1 tablet,bid), compound chlorzoxazone(2 tablets, tid)and gabapentin(1 tablet, tid) respectively for group I,II and III. To assess the analgesic effect, RVAS and MVAS were recorded before dosing and on the 1st, 2nd and 3rd day after dosing. To assess recovery of joint function after operation,the passive ROM of the knee joint on the 3rd, 4th and 5th day after dosing were recorded respectively.Result: On the 1st, 2nd and 3rd day after dosing, RVAS and MVAS scores of three groups were significantly lower than that before dosing, the difference was statistically significant(P<0.05). The PROM of the knee joint of three groups could reach 90 degrees on the 5th day after dosing. 6 cases in I group had adverse reactions, while 2 cases in II group and 2 cases in III group.Conclusion: According to the different situation of postoperative pain, to give personalized analgesic drugs, and carry out multimodal analgesia in advance during perioperative stage of knee joint replacement. That can get good results, bring less adverse reactions, and have better recovery of knee joint function.