Effect of popliteal plexus nerve combined with adductor muscle block on postoperative analgesia after TKA surgery
Objective To observe the effect of popliteal plexus block(PPB)combined with abductor muscle block(ACB)on postoperative analgesia after total knee arthroplasty(TKA)surgery.Methods Randomly selecte 125 patients who underwent TKA surgery at our hospital from January 2022 to June 2023 as the study subjects.They were divided into a conventional group(62 cases)and a combination group(63 cases)using a digital table method.The conventional group received postoperative analgesia using ACB,while the combination group received postoperative analgesia using PPB combined with ACB.The postoperative pain,postoperative self-control analgesia,postoperative recovery,and anesthesia safety of the two groups were compared.Results Under different analgesic modes,the visual analogue scale(VAS)scores of the combined group at rest 24 hours and 72 hours after surgery were(4.23±1.46)and(3.15±0.47)points,respectively,lower than those of the conventional group[(5.11±2.04)and(4.36±1.27)points].The VAS scores at 24 hours and 72 hours after surgery were(4.91±1.47)points and(3.77±0.28)points,respectively,lower than those in the conventional group[(5.33±2.04)points and(4.69±1.31)points].The effective number of postoperative patient-controlled intravenous analgesia(PCIA)compressions,total number of compressions,and number of pain relief cases in the combined group were(7.2±1.4),(4.2±1.2),and 32％(20/63),respectively,which were lower than those in the conventional group[(9.4±2.3),(5.4±1.4),and 47％(29/62)].The first postoperative time to get out of bed,time to resume au-tonomous activity,and hospital stay in the combined group were(20±5)hours,(23±5)hours,and(14±3)days,respectively,which were lower than those in the conventional group[(23±5)hours,(27±5)hours,and(17±4)days].The range of motion of the knee joint in the combined group was(68±10)° and(76±10)° 24 and 72 hours after surgery,respectively,which were higher than those in the conventional group[(62±10)° and(69±10)°].The quadriceps muscle strength at 24 hours and 72 hours after surgery was(3.77±0.25)and(4.52±1.36),respectively,which were higher than those in the conventional group[(3.12±0.76)and(4.13±0.52)](P＜0.05).The incidence of postoperative anesthesia-related side effects in the combined group was 10％(6/63),that in the conventional group was 8％(5/62)which had no significance(P＞0.05).Conclusion The combination of PPB and ACB in TKA postoperative analgesia can effectively alleviate postoperative pain in patients,reduce the number of PCIA compressions,accelerate the postoperative recovery process of patients,and promote lower limb function recovery.The combination of the two does not significantly increase the risk of anesthesia-related side effects and has high safety.
Total knee arthroplastyPopliteal plexus blockAbductor muscle blockPostoperative analge-siaAnesthesia safety
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