Abstract:

BACKGROUND: Clinicians have pay more and more attention to the perioperative pain relief recently, and some domestic hospitals have been carried out multi-modal analgesic therapy and other perioperative analgesic measures and gained remarkable achievement, but systematic perioperative pain relieve protocol is still deficient in most of the hospitals.
OBJECTIVE: To compare the short term clinical effects of the perioperative pain relief protocol between the multimodal and the non-multimodal pain relief protocols, and to investigate the more effective and normative perioperative pain relief protocol.
METHODS: From October 2010 to October 2011, forty patients who undertook the primary total knee arthroplasty in the Department of Orthopedics, Beijing Chao-yang Hospital, Capital Medical University were selected, and randomly divided into two groups according to different pain relief protocols: multimodal pain control group (n=20) and non-multimodal pain control group (n=20). Patients in the non-multimodal group adopted the conventional epidural control analgesia, and orally took non-steroidal anti-inflammatory drugs after the operation. However, the patients in the multimodal pain control group received the pre-emptive analgesia and femoral nerve block tube would also be done for the initial sustained and post-loading dose analgesia.
RESULTS AND CONCLUSION: The visual analog scale scores in the multimodal pain control group were lower than those in the non-multimodal pain control group at 6, 12 and 24 hours after operation, but there was no significant difference of the visual analog scale score between the two groups (P > 0.05). The activity pain in multimodal pain control group was lower than that in the non-multimodal pain control group at 2 days after operation, and the difference was significant between the two groups (P < 0.01). From the third day to the seventh day, the activity and rest pain in multimodal pain control group were lower than those in non-multimodal pain control group, and there was significant difference between two groups (P < 0.01). From the second day to the seventh day, range of motion of the knee joint in the multimodal pain control group was bigger than that in the non-multimodal pain control group, and the difference was significant between the two groups (P < 0.05). The multimodal pain control protocol can relieve the perioperative pain of the total knee arthroplasty effectively in short term, and can lead to a quick functional recover in patients.