| Background: Total knee arthroplasty(TKA)has become the main treatment method for severe knee diseases.It can significantly reduce the degree of joint pain and improve the function of joint movement and improve the quality of life of patients,but the postoperative pain rate of TKA is up to 90%.Some scholars have shown that acupuncture related meridian points can improve pain threshold,but there are few studies on specific acupuncture points and meridian points.Objective: The purpose of this study is to investigate the effect of perioperative acupuncture on pain after unilateral TKA,so as to provide valuable data for postoperative analgesia of TKA.Methods: In accordance with the inclusion criteria and exclusion criteria of this study,54 patients were selected and randomly divided into control group and experimental group with 27 patients in each group.The control group adopts TKA routine analgesia plan,that is,combined epidural anesthesia was used,femoral nerve block anesthesia and patient controlled analgesia pump(PCA)was applied after the operation,its total volume was100 ml,and the standard flow rate was 2.0ml/h,the controlled infusion dose was 0.5ml(single time),the controlled interval time was about 15 min and the extraction was performed 48 h after the operation.When the patient has pain within 48 hours after the operation,the flow valve can be pressed to increase the amount of fluid and make a record.If the patient has excruciating pain after surgery,tell the physician to assess the VAS score.If the VAS is greater than or equal to 7 points,the standby analgesic drug celecoxib capsule(celebrex)is temporarily administered and recorded as 0.2g.If the pain was not relieved after the application of celecoxib capsule for 0.5h,buguiazine hydrochloride injection(qiangtongding)was applied for 100 mg,and record the dose and frequency of the analgesic remedy.The experimental group combined the routine analgesic program of the control group with perioperative acupuncture treatment,and the time and frequency of acupuncture were fixed.Record pain VAS score of two groups patients in preoperative and postoperative 6 h,18 h,24 h,48 h,72 h,96 h,120 h under the motion state,and record the maximum flexion Angle(ROM)on the day before operation,2,3,4,5 days after operation,at the same time record drug dose and frequency of pain,pain of drug adverse reaction of the two groups.Results: After the two groups of data for statistical analysis,i found that the experimental group in postoperative 18 hours to 48 hours after operation was slightly better than the control group about exercise VAS score,but there is no obvious difference in the active ROM score and the ues of additional analgesic drugs and adverse reaction,there was no significant difference in the sports VAS scores at 6 hours after surgery and 72 hours and later after surgery.Conclusion: Through a small range of experiments and statistical analysis,this study concluded that the application of acupuncture treatment in the perioperative period can improve the pain after unilateral TKA to a certain extent,with good safety and operability.It has some certain clinical guiding significance for the analgesia of unilateral TKA,and it is worth further study to see whether it can be popularized in clinic. |
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