Effect of ultrasound combined with nerve stimulator in guiding saphenous nerve block on patients after total knee arthroplasty / 中国介入影像与治疗学

ABSTRACT

Objective: To observe the effect of ultrasound combined with neurostimulator in guiding saphenous nerve block (SNB) on elderly knee osteoarthritis (OA) patients after total knee arthroplasty (TKA). Methods: A total of 50 elderly OA patients who would undergo unilateral TKA were randomly divided into group A and group B (each n=25). Patients in Group A underwent ultrasound and nerve stimulator guided femoral nerve block (FNB), while in group B underwent ultrasound and nerve stimulator guided SNB. Visual analogue score (VAS), maximum knee flexion and quadriceps strength, the time of postoperative motor recovery and sensory recovery, as well as the complications before operation and 24 h, 48 h, 72 h, 1 week and 2 weeks after operation were recorded and compared. Results: There was no significant difference of VAS between groups at any time point (all P>0.05). The maximum knee flexion 48 h, 72 h, 1 week and 2 weeks after surgery in group A were all less than in group B (all P<0.05). Quadriceps muscle strength 24 h, 48 h and 72 h of post operation in group A were lower than in group B (all P<0.05). In group A, motor recovery time was (25.28±4.55)h, and sensory recovery time was (33.20±2.92)h, which in group B was (14.64±2.16)h and (28.84±3.27)h, respectively (both P<0.001). Within 2 weeks after operation, vomiting was observed in 2 cases of group A and 1 case of group B, while dizziness was noticed 1 case of group B. No adverse reaction such as hypotension occurred. Conclusion: Ultrasound combined with neurostimulator-guided SNB is safe and effective for managing OA patients after TKA, which is superior to FNB in promoting sensory and motor function recovery.