The effectiveness of analgesia after total knee replacement

DOI: https://doi.org/10.29296/25877305-2020-04-13
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Issue: 
4
Year: 
2020

U. Fan; A. Lychagin, MD, Associate Professor; Professor A. Gritsyuk, MD; S. Smetanin, MD, Associate Professor I.M. Sechenov First Moscow State Medical University (Sechenov University)

Objective. A prospective, randomized, single-center study was conducted involving 160 patients comprising four groups each with 40 people operated on. The patients underwent primary total knee replacement (TKR) under spinal anesthesia. Group 1 underwent periarticular local infiltration anesthesia (LIA); Group 2 had femoral nerve block; Group 3 had popliteal arterial area block; in Group 4 (a control one), multimodal analgesia was used to relieve postoperative pain. Results. The study showed the same level of pain with LIA (Group 1), femoral nerve block (Group 2), and periarterial blockade of the popliteal artery (Group 3); however, the dynamics of quadriceps muscle strength recovery (straight leg lifts) during the first 7 postoperative days were best in Group 1. The Oxford Knee Score (OKS) demonstrated that lower limb function improved significantly in the groups, without a statistically significant difference before and 6 and 12 months after surgery. Conclusion. LIA ensures adequate pain relief in the early postoperative period, which makes it possible to commence early active rehabilitation and to achieve good functional results during primary TKR.

Keywords: 
surgery
local infiltration anesthesia
total knee replacement
quadriceps muscle function
early rehabilitation



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