To explore the evaluation of the application of enhanced recovery after surgery(ERAS)during the perioperative period of total knee arthroplasty.

A total of 60 patients received TKA treatment in Ningxia Hui Autonomous Region People＇s Hospital were selected and divided into "conventional treatment group" and "ERAS group" . The preoperative and postoperative visual analogue scale(VAS), the Hospital for Special Surgery (HSS) knee scores, blood loss and the number of postoperative blood transfusions, postoperative complications, hospitalization time, hospitalization expenses and postoperative satisfaction were compared. Inclusion criteria: knee osteoarthritis; unilateral, initial TKA patients. Exclusion criteria: inflammatory arthritis; those who need special prosthesis for knee instability. The measurement data used two independent samples t test, the count data used the chi square test or Fisher exact probability method. The comparison of related data at different time points used repeated measures analysis of variance.

The VAS score in the ERAS group on the first day after the operation (F=67.67, P<0.05)and the VAS score after the operation on the third day after the operation(F=146.30, P<0.05) were lower than those in the conventional treatment group. There was no statistically significant difference in VAS scores in the resting state after seven days (F=1.20, P>0.05). The HSS score (F=485.83, P<0.05) in the ERAS group in one month after the surgery, and the HSS score in three months after the surgery (F=512.39, P<0.05) were higher than those in the conventional treatment group. The HSS scores of the two groups showed no statistically significant difference in six months after the surgery (F=0.17, P>0.05). The blood loss (t=4.27, P<0.05) and the number of blood transfusions (χ²=4.36, P<0.05) in the ERAS group were lower than those in the conventional treatment group. The incidence of postoperative nausea and vomiting in the ERAS group was lower than that in the conventional treatment group (χ²=4.32, P<0.05). The two groups had less limb venous thrombosis and urinary tract infection and postoperative incision complications, the difference was not statistically significant(all P>0.05). The average length of hospital stay in the ERAS group were (11.9±1.3)d and (14.6±1.5)d in the conventional treatment group (t=7.40, P<0.01). The average hospitalization cost of the ERAS group was less than the conventional treatment group (t=2.09, P<0.05). The satisfaction degree of the ERAS group was higher than that of the conventional treatment group (χ²=5.46, P<0.05).

No drainage after TKA, and four hours after operation can reduce the blood transfusion rate and relieve the postoperative pain of the patient. The application of ERAS in the perioperative period of TKA can reduce the incidence of postoperative nausea and vomiting, reduce the rate of blood transfusion, save medical expenses, and improve patient satisfaction.