| Objective The purpose was to compare the efficacy and safety of bupivacaine plus morphine for adductor canal block(ACB)in the treatment of pain after total knee arthroplasty compared with bupivacaine alone.Methods Included 62 patients who underwent elective total knee arthroplasty in the Hightech District of the First Affiliated Hospital of Anhui Medical University from May 2019 to July 2020,aged 18-75 years,regardless of gender,ASA classification I-III,Randomly divided into bupivacaine group(GB)and morphine group(GM),each with 31 cases,GB group received 0.375% bupivacaine 20 ml for adductor tube block,GM group received0.375 bupivacaine and 5mg morphine for a total of 20 ml for adductor tube block.Record the resting and exercise VAS scores of the two groups of patients immediately after extubation,and at 6,12,24,and 48 hours after surgery,and opioids drug consumption on the first and second day after the operation,quadriceps muscle strength of two days after surgery,and related postoperative complications were also recorded.Results The VAS-R/M scores of the GM group at 6h,12 h and 24 h were significantly lower than those of the GB group(P<0.05),and the consumption of opioids drug of GM(10.0±4.8 mg)on the first day after surgery was lower than that of the GB group(13.5±5.5mg),the difference was statistically significant(P<0.01),but there was no significant difference in quadriceps muscle strength and related complications two days after surgery(P>0.05).Conclusion After total knee arthroplasty,the postoperative analgesic effect of adductor canal block with morphine combined with bupivacaine is better than bupivacaine alone,which can reduce postoperative opioid dosage without affecting quadriceps muscle strength and the incidence of postoperative complications. |
