Progress of peripheral nerve block in analgesic management after total knee arthroplasty

doi:10.3877/cma.j.issn.1674-134X.2020.04.016

Abstract

Abstract:

Total knee arthroplasty (TKA) is the most effective treatment for end-stage osteoarthritis or rheumatoid arthritis of the knee. Postoperative pain is an important factor affecting functional reconstruction, and multimodal analgesia can provide a "comfortable" rehabilitation environment for TKA patients. Peripheral nerve block is an important component of multimodal analgesia, which includes femoral nerve block, adductor canal block, sciatic nerve block, obturator nerve block, local Infiltration anesthesia, and so on. The advantages of these methods are effect, relative simple procedure and less side effects. This review mainly retrieved literatures about the application of peripheral nerve block in the management of postoperative analgesia after TKA in recent five years, and tried to find out the most beneficial and safest method of peripheral nerve block after operation by comparing the analgesic effect, the promotion of functional reconstruction after operation and side effects of different blockade modes. This review found that the peripheral nerve block may play an increasing prominent role in the postoperative pain management of TKA patients, which can promote the postoperative functional rehabilitation and significantly reduce the occurrence of side effects of analgesics. In addition, femoral nerve block is the gold standard of peripheral nerve block, and adductor canal block is an ideal alternative method.

Key words: Arthroplasty, replacement, knee, Nerve block, Pain management

Bo Wang, Buhua Dong. Progress of peripheral nerve block in analgesic management after total knee arthroplasty[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(04): 486-490.

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References 40

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种类	适应证	优点	缺点
FNB	膝、髋关节置换术	镇痛效果确切	股四头肌麻痹
SNB	膝、髋关节置换术	降低阿片类药物用量	坐骨神经麻痹
ACB	膝关节置换术	缩短住院日	作用局限于膝关节
LIA	膝关节置换术	效果确切操作简便	内侧局部肿胀

种类	适应证	优点	缺点
FNB	膝、髋关节置换术	镇痛效果确切	股四头肌麻痹
SNB	膝、髋关节置换术	降低阿片类药物用量	坐骨神经麻痹
ACB	膝关节置换术	缩短住院日	作用局限于膝关节
LIA	膝关节置换术	效果确切操作简便	内侧局部肿胀

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