The effect of ultrasound-guided continuous saphenous nerve block on preemptive analgesia in elderly patients undergoing unilateral total knee arthroplasty under general anesthesia / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of ultrasound-guided continuous saphenous nerve block on preemptive analgesia in elderly patients undergoing unilateral total knee arthroplasty(TKA) under general anesthesia.Methods:A total of 120 elderly patients who received unilateral TKA in the Affiliated Hospital of Jining Medical College from June 2020 to October 2020 were enrolled and they were divided into group A (saphenous nerve block + general anesthesia), group B (femoral nerve block + general anesthesia) and group C (simple general anesthesia) by random numbering method, with 40 cases in each group. The visual analogue pain (VAS) scores, knee range of motion, RS agitation scores and Ramsay sedation scores at different time points after surgery and postoperative recovery and analgesia were compared among the three groups.Results:The static state and dynamic state VAS scores in the group A and group B at 6, 12, 24, 48 h after the surgery had no significant differences ( P>0.05). The knee range of motion in the group A at 6, 12, 24, 48 h after the surgery were higher than that in group B and group C (74.8 ± 8.1)° vs. (68.4 ± 8.2)°and (63.2 ± 7.0)°, (77.4 ± 10.9)°vs.(73.0 ± 10.0)° and (68.6 ± 8.3)°, (82.6 ± 10.4)° vs. (77.4 ± 9.6)°and (73.2 ± 8.3)°, (91.8 ± 6.1)° vs. (86.8 ± 6.6)° and (82.8 ± 5.3)°, the differences were statistically significant ( P<0.05). The RS agitation scores and Ramsay sedation scores in the group A and group B had no significant differences ( P>0.05). The first time to the ground in the group A was shorter than that in the group B (20.9 ± 3.0) h vs. (27.4 ± 3.5) h; the walking distance in the group A was longer than that in the group B (7.1 ± 1.6) m vs. (5.2 ± 1.3) m, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound-guided continuous saphenous nerve block has a good postoperative analgesic effect in elderly patients with unilateral TAK under general anesthesia. It can promote the recovery of directional force and knee range of motion in patient.