Adductor canal blockade for early post-operative pain analgesia after primary total knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2018.02.009

Abstract

Abstract:

Objective

To evaluate the efficacy of adductor canal block(ACB) on pain management and early rehabilitation after total knee arthroplasty (TKA).

Methods

A total of 40 patients undergoing primary unilateral TKA in the first affilicated hospital of Harbin Medical University were randomly divided into two groups: ACB combined with parecoxib group (test group) and only parecoxib group (control group). Primary TKA patients were included, and the patients with severe infection or mental diseases were excluded. Adductor canal block was immediately performed. Perioperative data was calculated for statistical analysis.The data were analyzed with independent-samples t test, non-parameters Wilcoxon symbols test and chi-square test.

Results

Comparing the test group with the control group, significant differences were found in rest pain, activity pain in early stage postoperatively (postoperative 6 h~72 h active VAS: Z= -3.124, -2.157, -2.044, -2.467, -2.471, all P < 0.05; postoperative 6 h~24 h rest VAS: Z=-2.310, -2.409, -2.208, P<0.05). No difference was found in knee function and length of hospital stay between two groups(P>0.05). The patients in the test group showed better compliance of rehabilitation. Further more, no ACB complication was found.

Conclusion

ACB can effectively alleviate postoperative pain in TKA patients, and it could be helpful for fast functional recovery.

Key words: Arthroplasty, replacement, knee, Analgesia, Nerve block

Ruixuan Liu, Ning Liu, Maitao Jiang, Tao Zhang, Weixin Chen, Wenbo Wang. Adductor canal blockade for early post-operative pain analgesia after primary total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(02): 192-196.

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Figures/Tables 4

References 14

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组别	例数	年龄[岁，(±s)/M(P₂₅，P₇₅)]	性别(男/女)	BMI[kg/m²，(±s)]	伸直[°，(±s)/M(P₂₅，P₇₅)]	屈曲[°，(±s)/M(P₂₅，P₇₅)]	肌力[级，M(P₂₅，P₇₅)]	静止VAS[分，M(P₂₅，P₇₅)]	活动VAS[分，M(P₂₅，P₇₅)]
实验组	20	73.0(70.0，78.0)	4/16	24.4±2.7	13.1±10.1	102.5±11.8	4.0(4.0，5.0)	2.0(2.0，2.8)	7.0(7.0，8.0)
对照组	20	72.2±8.6	4/16	23.6±2.1	12.5(4.5，17.8)	105.0(90.0，110.0)	4.0(4.0，5.0)	2.0(2.0，2.7)	8.0(7.0，8.0)
统计值	?	Z＝0.190	χ²＝0.000	t＝1.143	Z＝0.502	Z＝0.166	Z＝0.638	Z＝0.062	Z＝－0.958
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	年龄[岁，(±s)/M(P₂₅，P₇₅)]	性别(男/女)	BMI[kg/m²，(±s)]	伸直[°，(±s)/M(P₂₅，P₇₅)]	屈曲[°，(±s)/M(P₂₅，P₇₅)]	肌力[级，M(P₂₅，P₇₅)]	静止VAS[分，M(P₂₅，P₇₅)]	活动VAS[分，M(P₂₅，P₇₅)]
实验组	20	73.0(70.0，78.0)	4/16	24.4±2.7	13.1±10.1	102.5±11.8	4.0(4.0，5.0)	2.0(2.0，2.8)	7.0(7.0，8.0)
对照组	20	72.2±8.6	4/16	23.6±2.1	12.5(4.5，17.8)	105.0(90.0，110.0)	4.0(4.0，5.0)	2.0(2.0，2.7)	8.0(7.0，8.0)
统计值	?	Z＝0.190	χ²＝0.000	t＝1.143	Z＝0.502	Z＝0.166	Z＝0.638	Z＝0.062	Z＝－0.958
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

活动VAS评分	组别	例数	术后6 h	术后12 h	术后24 h	术后48 h	术后72 h
	实验组	20	4(3，4)	4(4，5)	5(4，6)	4(4，5)	3(3，4)
	对照组	20	5(4，5)	5(5，6)	5(5，7)	5(4，6)	4(3，5)
	Z值	?	－3.124	－2.157	－2.044	－2.467	－2.471
	P值	?	<0.05	<0.05	<0.05	<0.05	<0.05
静息VAS评分	组别	例数	术后6 h	术后12 h	术后24 h	术后48 h	术后72 h
	实验组	20	2.0(2.0，3.7)	3.0(3.0，4.0)	3.5(3.0，5.0)	3.0(3.0，3.0)	2.0(2.0，3.0)
	对照组	20	3.0(3.0，4.0)	4.0(4.0，5.0)	4.5(4.0，5.7)	3.0(3.0，4.0)	2.0(2.0，2.7)
	Z值	?	－2.310	－2.409	－2.208	－0.663	0.297
	P值	?	<0.05	<0.05	<0.05	>0.05	>0.05

活动VAS评分	组别	例数	术后6 h	术后12 h	术后24 h	术后48 h	术后72 h
	实验组	20	4(3，4)	4(4，5)	5(4，6)	4(4，5)	3(3，4)
	对照组	20	5(4，5)	5(5，6)	5(5，7)	5(4，6)	4(3，5)
	Z值	?	－3.124	－2.157	－2.044	－2.467	－2.471
	P值	?	<0.05	<0.05	<0.05	<0.05	<0.05
静息VAS评分	组别	例数	术后6 h	术后12 h	术后24 h	术后48 h	术后72 h
	实验组	20	2.0(2.0，3.7)	3.0(3.0，4.0)	3.5(3.0，5.0)	3.0(3.0，3.0)	2.0(2.0，3.0)
	对照组	20	3.0(3.0，4.0)	4.0(4.0，5.0)	4.5(4.0，5.7)	3.0(3.0，4.0)	2.0(2.0，2.7)
	Z值	?	－2.310	－2.409	－2.208	－0.663	0.297
	P值	?	<0.05	<0.05	<0.05	>0.05	>0.05

膝关节屈曲活动度	组别	例数	术后1 d	术后2 d	术后3 d	术后7 d	术后14 d
	实验组	20	74 (71，79)	90 (90，101)	110 (105，110)	120 (110，120)	120 (119，120)
	对照组	20	70 (66，77)	90 (90，90)	107 (104，110)	117 (110，120)	120 (119，120)
	Z值	?	1.518	1.821	0.610	0.744	0.460
	P值	?	>0.05	>0.05	>0.05	>0.05	>0.05
膝关节伸直活动度	组别	例数	术后1 d	术后2 d	术后3 d	术后7 d	术后14 d
	实验组	20	10.0(10.0，15.0)	10.0(10.0，10.0)	10.0(0.0，10.0)	0.0(0.0，2.5)	0.0(0.0，2.5)
	对照组	20	10.0(10.0，15.0)	10.0(10.0，10.0)	10.0(7.5，10.0)	0.0(0.0，0.0)	0.0(0.0，0.0)
	Z值	?	－0.306	0.065	0.174	0.521	0.781
	P值	?	>0.05	>0.05	>0.05	>0.05	>0.05

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