Study on analgesic effect of adductor canal block under different concentrations of ropivacaine combined with lateral femoral cutaneous nerve block after total knee arthroplasty
Objective To compare the analgesic effects of ultrasound-guided adductor canal block(ACB)under different concentrations of ropivacaine combined with lateral femoral cutaneous nerve block(LFCNB)after total knee arthroplasty(TKA)and their influence on the knee joint function.Methods Ninety patients un-dergoing primary unilateral TKA under subarachnoid block were selected and randomly divided into three groups:0.20%ropivacaine(group A),0.25%ropivacaine(group B),and 0.30%ropivacaine(group C).All groups conducted ACB+LFCNB preoperatively.Postoperative visual analog scale(VAS)scores,sufentanil consumption at postoperative 24 h,time to first rescue analgesia,postoperative range of motion(ROM)of the knee joint,quadriceps strength and postoperative complications were recorded.Results Compared with the group A,the resting and moving VAS scores at postoperative 4,8,12,24 h in the group B and C were de-creased(P<0.05),the sufentanil consumption amount within postoperative 24 h was decreased(P<0.05),the first rescue analgesia time was prolonged(P<0.05),ROM on the operation day was increased(P<0.05).The above results had no statistical difference between the group B and group C(P>0.05).There were no statistically significant differences in knee ROM on postoperative 1,2 d,postoperative quadriceps strength and complications incidence rates among the three groups(P>0.05).Conclusion In the application of ACB+LFCNB in the patients with TKA,compared with 0.20%ropivacaine,0.25%and 0.30%ropivacaine could improve early postoperative pain and facilitate the postoperative functional recovery of the knee joint.Additionally,0.25%ropivacaine could provide the same analgesic efficacy as 0.30%ropivacaine.
ropivacaineadductor canal blocklateral femoral cutaneous nervetotal knee arthroplastyknee joint function