Intraoperative local infiltration of analgesia combined with enhanced recovery after surgery in total knee replacement

doi:10.3877/cma.j.issn.1674-134X.2020.06.005

Abstract

Abstract:

Objective

To investigate the effects of intraoperative local infiltration of analgesia combined with enhanced recovery after surgery (ERAS)-rehabilitation in the arthroplasty of knee.

Methods

Patients who underwent total knee replacement from January 1, 2016 to December 31, 2019 in the orthopedics department of Sun Yat-sen Memorial Hospital were divided into experimental group and control group according to surgical methods and postoperative rehabilitation. The t test was applied to compare the 24 h-drainage, hemoglobin reduction, total blood loss, visual analogue scale(VAS)and post-operative Hospital for Special Surgery (HSS) score on the seventh day and the average days of hospitalization.

Results

Compared with the control group, 24 h-drainage volume, hemoglobin reduction, total blood loss and VAS score in the experimental group were significantly lower(t =21.301, 8.591, 15.834, 13.350, all P<0.001), and the HSS score of the seventh day in the experimental group was higher than that of the seventh day in the control group(t=16.015, P<0.001).

Conclusion

Intraoperative local infiltration of analgesia combined with ERAS-rehabilitation in total knee replacement reduce the blood loss, improve the treatment effect, reduce the average length of stay and the average total length of stay, and accelerate the recovery of patients.

Key words: Enhanced recovery after surgery, Arthroplasty, replacement, knee

Zhiqing Cai, Jie Xu, Meiling Qiu, Hao Sun, Deng Li, Wenhui Zhang, Meiyi Chen, Ruofan Ma. Intraoperative local infiltration of analgesia combined with enhanced recovery after surgery in total knee replacement[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(06): 675-679.

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References 21

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组别		实验组	对照组	统计值	P值
例数		235	219
年龄[岁，(±s)]		71.00±12.13	68.83±16.87	t＝1.582	>0.05
病程[年，(±s)]		7.38±4.00	6.78±3.56	t＝1.684	>0.05
BMI[kg/m²，(±s)]		26.32±3.11	26.72±4.32	t＝1.138	>0.05
术前血红蛋白[g/L，(±s)]		127.75±19.86	125.69±10.63	t＝1.364	>0.05
HCT(±s)		0.38±0.16	0.42±0.27	t＝1.936	>0.05
性别(例)
	男性	64	53
	女性	171	166	χ²＝0.545	>0.05
诊断(例)
	类风湿关节炎	44	49
	骨关节炎	191	170	χ²＝0.928	>0.05

组别		实验组	对照组	统计值	P值
例数		235	219
年龄[岁，(±s)]		71.00±12.13	68.83±16.87	t＝1.582	>0.05
病程[年，(±s)]		7.38±4.00	6.78±3.56	t＝1.684	>0.05
BMI[kg/m²，(±s)]		26.32±3.11	26.72±4.32	t＝1.138	>0.05
术前血红蛋白[g/L，(±s)]		127.75±19.86	125.69±10.63	t＝1.364	>0.05
HCT(±s)		0.38±0.16	0.42±0.27	t＝1.936	>0.05
性别(例)
	男性	64	53
	女性	171	166	χ²＝0.545	>0.05
诊断(例)
	类风湿关节炎	44	49
	骨关节炎	191	170	χ²＝0.928	>0.05

组别	例数	术后24 h引流量(ml)	HCT减少量	24 h血红蛋白减少量(g/L)	24 h总失血量(L)
实验组	235	127.190±63.460	0.052±0.013	17.690±9.450	0.449±0.244
对照组	219	305.830±110.490	0.098±0.006	26.170±11.540	0.683±0.268
t值		21.301	47.829	8.591	15.834
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	术后24 h引流量(ml)	HCT减少量	24 h血红蛋白减少量(g/L)	24 h总失血量(L)
实验组	235	127.190±63.460	0.052±0.013	17.690±9.450	0.449±0.244
对照组	219	305.830±110.490	0.098±0.006	26.170±11.540	0.683±0.268
t值		21.301	47.829	8.591	15.834
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	术前HSS评分	术后第7天HSS评分	术前VAS评分	术后第7天VAS评分
实验组	235	41.7±33.2	86.9±5.1	6.6±2.7	2.4±0.9
对照组	219	43.5±24.1	79.4±4.8	6.3±2.2	3.7±1.1
t值		0.668	16.015	1.311	13.35
P值		>0.05	<0.001	>0.05	<0.001

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