Clinical Study Of Adductor Canal Nerve Block At Different Sites After Knee Joint Operation

Objective:after knee arthroscopy and knee arthroplasty,adductor canal nerve block was performed with a mixture of levobupivacaine hydrochloride and dexamethasone at different sites of adductor canal,and a self-controlled intravenous analgesia pump was equipped.The time of the first leg lifting,the time of pa-in,the dose of intravenous analgesics(sufentanil)and the occurrence of nausea and vomiting were observed.By comparing each observation index to explore the best block site of the two kinds of surgery,so as to explore the best block site of adductor canal nerve block after knee operation.To provide a better scheme for postoperative analgesia and make the patients more com-fortable during the perioperative period.Methods:60 patients undergoing knee arthroscopy and 60 patients undergoing knee arthroplasty under spinal anesthesia in the affiliated Hospital of Yan’an University from November 2019 to January 2021 were randomly divided into two groups: adductor tube proximal knee arthroscopy group(A,0.375% levobupivacaine 20ml+3mg dexamethasone)and adductor canal middle end knee arthroscopy group(B,0.375% levobupivacaine 20ml+3mg dexamethasone),30 cases in each group.Proximal adductor canal knee arthroplasty group(C,0.375% levobupivacaine 20ml+3mg dexamethasone)and middle adductor tube knee joint replacement group(D,0.375% levobupivacaine 20ml+3mg dexamethasone),30 cases in each group.Adductor canal nerve block was performed with nerve block needle under the guidance of ultrasound at the end of the operation.The injection was completed within1 min and then observed for another 30 min,Please be sent to the ward without discomfort.The injection time of lumbar anesthesia,leg lifting time of affected limb,pain time of affected limb,analgesic dose three days after operation and nausea and vomiting after operation were recorded.As only the basic condition of the patient was observed three days after operation,when the patient still did not have the first leg lift time or pain occurrence time three days after operation,the occurrence time was recorded as 4320 min.Results:1.There was no significant difference in gender composition,age,BMI and operation time of patients undergoing knee arthroscopy.2.Comparison of the time difference of the first leg lift after arthroscopic surgery showed that the time of the first leg lift in the patients with middle adductor canal nerve block was less than that of the patients with proximal adductor canal nerve block,and the difference between the two results was statistically significant(P < 0.05).3.Comparison of pain time difference after knee arthroscopy showed that there was no statistical significance between the middle end and the proximal end of the two groups(P >0.05).4.In knee arthroscopic surgery,the dosage of analgesics for proximal adductor nerve block and middle adductor nerve block was about the same,and there was no significant difference between them(P > 0.05).5.There was no significant difference in the incidence of nausea and vomiting between the two groups after knee arthroscopy(P > 0.05).6.There was no significant difference in gender composition,age,BMI and operation time in patients undergoing knee arthroplasty.7.Comparison of the time difference of the first leg lift after knee replacement showed that the time of the first leg lift in patients with middle adductor canal nerve block was less than that of proximal adductor canal nerve block,and the difference between the two results was statistically significant(P < 0.05).8.Comparison of pain time difference after knee replacement showed that there was no statistical significance between the middle end and the proximal end of the two groups(P >0.05).9.In knee arthroplasty,the dosage of analgesics used in proximal adductor canal nerve block was significantly lower than that in middle adductor tube nerve block,and the difference was statistically significant(P < 0.05).10.There was no significant difference in the incidence of nausea and vomiting between the two groups after knee arthroplasty(P > 0.05).Conclusion:1.In knee surgery,the middle adductor canal nerve block has more advantages than the proximal adductor canal nerve block.2.adductor canal nerve block is more perfect for postoperative analgesia after knee arthroscopy,but it is not complete for postoperative analgesia after knee arthroplasty,But But combined with intravenous analgesia can obtain perfect analgesia.