2024, Vol. 28 ›› Issue (24): 3833-3838

Effect of adductor canal block and single sciatic nerve block combined with analgesic drugs on pain after total knee arthroplasty

Geng Haoyang1, Liu Wenping1, Wang Guorui1, Liu Bin1, Wang Wei2, Ma Zhanqiao1, Wang Jianhua1   

Abstract: BACKGROUND: Total knee arthroplasty is an effective treatment for late-stage osteoarthritis, but postoperative pain and joint function recovery are the main challenges. Nerve block and mixed drug injection are two common pain relief methods, but the effect of their combined use is still unclear.
OBJECTIVE: To investigate the effects of ultrasound-guided continuous adductor canal block+single sciatic nerve block+“cocktail” mixed drug analgesia on postoperative pain relief and joint function recovery in total knee arthroplasty.
METHODS: 120 patients with osteoarthritis admitted to Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine from January to May 2022 were randomly divided into two groups (n=60). The observation group received ultrasound-guided continuous adductor canal block+single sciatic nerve block+”cocktail” mixed drug analgesia. The control group received ultrasound-guided continuous adductor canal block+single sciatic nerve block. The differences in visual analog scale score, hospital for special surgery score, pain mediators, expression levels of inflammatory factors, the occurrence of adverse reactions, and postoperative barehanded muscle strength test were compared between the two groups.  
RESULTS AND CONCLUSION: (1) The visual analog scale scores at rest and exercise were lower in the observation group than those in the control group at 6, 8, 12, 24, 48, and 72 hours postoperatively (P < 0.05). (2) Hospital for special surgery scores at 1 and 3 months postoperatively were significantly higher in the observation group than those in the control group (P < 0.05). (3) In terms of pain mediators and inflammatory factors, the expression levels were significantly lower in the observation group than those in the control group (P < 0.05). (4) There was no statistically significant difference in terms of adverse effects and postoperative barehanded muscle strength examination between the two groups (P > 0.05). (5) In total knee arthroplasty, ultrasound-guided continuous adductor canal block and single sciatic nerve block, together with a “cocktail” mixed drug analgesia injected into the joint cavity, can provide excellent analgesia, facilitate the recovery of joint function, and relieve postoperative pain and inflammation with a high degree of safety.

Key words: continuous adductor canal block, single sciatic nerve block, total knee arthroplasty, mixed drug, pain