Abstract:

BACKGROUND: Acute pain during the peri-replacement period after total knee arthroplasty can impede the early rehabilitation exercises and increase the complications. Although the researchers have proposed a series of new ways and confirmed its effectiveness, the complications of drug abuse and nerve block cannot be avoided. Looking for a safe and effective analgesic program has become an important issue in joint replacement.
OBJECTIVE: To evaluate the therapeutic effect and safety of multimodal pain control protocol by periarticular injection of composite narcotic drugs on postoperative pain and functional rehabilitation after total knee arthroplasty．
METHODS: Between May 2009 and May 2010, 80 patients undergoing unilateral total knee arthroplasty were divided into two groups. The patients (n=38) in control group received the treatment of femoral nerve block or patient-controlled epidural analgesia; the patients (n=42) in the experimental group were treated with multimodal pain control protocol by periarticular injection of composite narcotic drugs.
RESULTS AND CONCLUSION: At 6, 12 and 24 hours and 2 and 3 days after replacement, the visual analogue scale score of the experimental group was lower than that of the control group (P < 0.05). There was no significant difference of visual analogue scale score between two groups at 4 and 5 days after replacement (P > 0.05). Compared with control group, the short-term pain was reduced, time for active and passive flexion 90° was significantly shorter after replacement, and the walker assisted walking fields time was significantly decreased in the experimental group (P < 0.05). The patients in the two groups had the similar incidence of adverse reactions, and no wound infection or delayed healing appeared due to the rational use of drainage. Multimodal pain control protocol after total knee arthroplasty as a secure and effective analgesic program can significantly reduce the pain after replacement.