The analgesic effect of different position adductor canal block guided by ultrasound for senile patients after total knee arthroplasty

doi:10.3877/cma.j.issn.2096-0263.2022.06.008

Abstract

Abstract:

Objective

To investigate the analgesic effect of ultrasound guided adductor tube block in different positions in elderly patients undergoing unilateral total knee arthroplasty under general anesthesia.

Methods

64 elderly patients (34 males, 30 females, 65-83 years old) who underwent unilateral knee arthroplasty in the First Hospital of Qinhuangdao from September 10, 2019 to June 30, 2021 were prospectively collected and divided into two groups according to the random number table method (n=32).The control group received ultrasound-guided proximal adductor tube block. Observation group was distal adductor tube block.The operation time, nerve block operation time, intraoperative blood loss and drainage volume within 48 hours after operation were recorded. The degree of postoperative pain, times of analgesic pump compression and analgesic relief, quadriceps muscle strength and knee joint activity were recorded.

Results

All 64 patients were followed up for 10-12 months. There were no significant differences in operation time, nerve block operation time, intraoperative blood loss, postoperative drainage volume, and postoperative analgesic drug recovery between the two groups. The VAS score and limb activity of the two groups at different time points after operation were analyzed by repeated measures ANOVA. The results showed that there were statistically significant differences in VAS score at different time points in the resting state (F=29.342, P=0.000). There was a significant difference in VSA score between the two groups at the time of activity (F=12.295, P=0.001), and there was a significant difference between the two groups at different time (F=3.373, P=0.010). Postoperative quadriceps muscle strength was significantly different between the two groups (F=6.918, P=0.011), knee joint range of motion was significantly different between the two groups (F=7.263, P=0.009), and the difference was statistically significant at different time points (F=25.238, P=0.001).

Conclusion

Distal adductor tube block can provide ideal analgesic effect for elderly patients after knee arthroplasty under general anesthesia. It has little effect on quadriceps muscle strength and is beneficial to early recovery of motor function.

Key words: Ultrasonic guidance, Adductor canal block, Total knee arthroplasty, Postoperative analgesia

Lijie Zhou, Xianlei Wang, Zhenyu Wu, Wenchao Liu, Yang Yu. The analgesic effect of different position adductor canal block guided by ultrasound for senile patients after total knee arthroplasty[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(06): 367-373.

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References 20

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组别	例数	性别（例，男/女）	年龄（岁， ±s ）	ASA（例，Ⅱ/Ⅲ）	BMI（kg/m²， ±s ）	术前并发症（例）
组别	例数	性别（例，男/女）	年龄（岁， ±s ）	ASA（例，Ⅱ/Ⅲ）	BMI（kg/m²， ±s ）	高血压	糖尿病	冠心病
对照组	32	18/14	70.47±5.08	20/12	23.93±3.48	22	12	15
观察组	32	16/16	71.75+4.84	21/11	23.91±3.24	20	18	19
统计值		χ²=0.251	t=1.033	χ²=0.068	t=0.028	χ²=0.277	χ²=2.259	χ²=1.004
P值		0.616	0.306	0.794	0.978	0.793	0.133	0.316

组别	例数	性别（例，男/女）	年龄（岁， ±s ）	ASA（例，Ⅱ/Ⅲ）	BMI（kg/m²， ±s ）	术前并发症（例）
组别	例数	性别（例，男/女）	年龄（岁， ±s ）	ASA（例，Ⅱ/Ⅲ）	BMI（kg/m²， ±s ）	高血压	糖尿病	冠心病
对照组	32	18/14	70.47±5.08	20/12	23.93±3.48	22	12	15
观察组	32	16/16	71.75+4.84	21/11	23.91±3.24	20	18	19
统计值		χ²=0.251	t=1.033	χ²=0.068	t=0.028	χ²=0.277	χ²=2.259	χ²=1.004
P值		0.616	0.306	0.794	0.978	0.793	0.133	0.316

组别	例数	手术时间（min）	操作时间（min）	出血量（ml）	引流量（ml）
对照组	32	98±10	9.2±2.3	69±19	234±36
观察组	32	97±11	8.7±1.8	67±19	222±34
t值		0.293	0.844	0.533	1.429
P值		0.770	0.402	0.596	0.158

组别	例数	手术时间（min）	操作时间（min）	出血量（ml）	引流量（ml）
对照组	32	98±10	9.2±2.3	69±19	234±36
观察组	32	97±11	8.7±1.8	67±19	222±34
t值		0.293	0.844	0.533	1.429
P值		0.770	0.402	0.596	0.158

组别	例数	术后4 h	术后8 h	术后12 h	术后24 h	术后48 h	F值	P值
对照组	32	1.68±0.69	2.47±0.72	2.72±0.68	2.68±0.78	2.21±0.49	11.932	0.000
观察组	32	1.44±0.62	2.50±0.62	2.41±0.71	2.71±0.85	2.03±0.54	15.055	0.000
F值		2.318	0.035	3.209	0.023	2.122
P值		0.133	0.853	0.078	0.879	0.150

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