关键词: 膝关节置换术, 神经阻滞, 自控静脉镇痛

Abstract: ［Abstract］ Objective〖HTSS〗To observe the effect of ultrasound-guided femoral nerve combined with sciatic nerve block and patient-controlled intravenous analgesia for postoperative analgesia after total knee arthroplasty.
Methods〖HTSS〗One hundred patients undergoing elective fitting line of knee replacement as object, according to the random indicator method were divided into two groups, 50 cases in each group. At the end of operation, the observation group was treated with femoral nerve combined with sciatic nerve block analgesia under the guidance of ultrasound, and the control group was treated with controlled intravenous analgesia. Visual Analogue Scale(VAS) was used to compare the analgesic effects of the two groups, and the postoperative recovery and adverse reactions were observed.
Results〖HTSS〗The VAS score of the observation group was not statistically significant compared with the control group(P＞0.05), and the VAS score of 4, 12, 24, 48, 72 h after the operation was significantly lower than that of the control group(P＜0.05). The time of active straight leg elevation of 45 degrees and active flexion of knee up to 90 degrees were significantly shorter than that of the control group(P＜0.05), and the knee joint activity of the discharged knee was significantly higher than that of the control group(P＜0.05). After 72 h, the incidence of adverse reactions in the observation group was 24.00%, and the incidence of adverse reactions in the control group was 46.00%, the difference was statistically significant(P＜0.05).
Conclusion〖HTSS〗Ultrasound guided femoral nerve combined with sciatic nerve block can effectively relieve the pain after knee replacement, reduce the incidence of adverse reactions and accelerate functional recovery.

Key words: knee arthroplasty, nerve block, self controlled intravenous analgesia