Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (44): 7114-7119.doi: 10.3969/j.issn.2095-4344.2015.44.012

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Total knee arthroplasty analgesia: gabapentin combined with continuous femoral nerve block

Guo Xiu-zhen1, Gao Bin-li2   

  1. 1Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China; 2Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China
  • Received:2015-08-17 Online:2015-10-22 Published:2015-10-22
  • Contact: Gao Bin-li, Master, Chief physician, Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China
  • About author:Guo Xiu-zhen, Associate chief nurse, Department of Anesthesiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China
  • Supported by:

    the Youth Innovation Foundation of Inner Mongolia Medical University, No. YKD2012QNCX017

Abstract:

BACKGROUND: Traditional analgesia method can relieve the pain after total knee arthroplasty, but the prognosis is poor and drug dependence is strong. Therefore, it is of great significance to study the analgesic drugs in perioperative period of total knee arthroplasty.
OBJECTIVE: To explore the analgesic effect of gabapentin combined with continuous femoral nerve block on total knee arthroplasty. 
METHODS: A total of 48 patients with knee osteoarthritis receiving total knee arthroplasty in the Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University from October 2013 to October 2014 were  
enrolled in this study. Using general anesthesia, femoral nerve block was conducted before anesthesia. Analgesia pump was connected after arthroplasty. Patients were randomized to two groups. The control group received multimodal analgesia, and the experimental group received gabapentin combined with continuous femoral nerve block analgesia. Patient’s pain was scored by using resting, activity visual analog scale. Postoperative quality of life, range of motion of knee joint and complications were observed.
RESULTS AND CONCLUSION: No significant difference in preoperative resting pain and activity pain was detected between the two groups (P > 0.05). Visual analog scale scores were decreased with time prolonged after arthroplasty in both groups. Visual analog scale scores of resting pain and activity pain were significantly lower in the experimental group than in the control group at 1, 3 and 7 days and 1 month (P < 0.05). Range of motion was significantly larger in the experimental group than in the control group at 3-7 days after arthroplasty (P < 0.05). Activity of daily living score, physical function score, mental function score and social function score were significantly higher in the experimental group than in the control group (P < 0.05). The complication rate was significantly lower in the experimental group than in the control group (17%, 46%, P < 0.05). These data indicate that during perioperative period of total knee arthroplasty, analgesic effect of gabapentin combined with continuous femoral nerve block is ideal. In particular, in patients with acute pain within 48 hours, their combination can promote early rehabilitation of the patient’s knee, and few side effects are found.
中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Prosthesis Implantation, Arthroplasty, Replacement, Knee, Femoral Nerve, Analgesia, Tissue Engineering