| Objective To investigate the analgesic effect of ultrasound-guided adductor canal combined with infiltration between the popliteal artery and capsule of the knee(IPACK) block in patients undergoing total knee arthroplasty(TKA). Methods From January 2017 to April 2020, 80 patients (aged 54~85 years) scheduled for TKA in the Third Affiliated Hospital of Anhui Medical University (the First People's Hospital of Hefei City) were selected as the research objects, allocated to American Society of Anesthesiologists(ASA) grade I~III.They were randomly divided into two groups using a random number table method:adductor canal block alone group (group S) and adductor canal + IPACK block group (group I),40 of each. All patients were performed general anesthesia under tracheal intubation or laryngeal mask before ultrasound-guided local block, and received patient-controlled intravenous analgesia(PCIA) after surgery. Numerical Rating Scale(NRS) score were recorded at the 4 (T1),8 (T2),12(T3), 24(T4) and 48 hour(T5) after surgery. Patients were injected with flurbiprofen 50 mg intravenous if NRS score was larger than 4. The times of PCIA self-administration, range of joint motion, comfort scores and the adverse effects within 48 hours after surgery were recorded. Results Compared with group S, patients in group I had lower resting and exercise NRS scoresat time T1~T3,and the difference was statistically significance(P<0.001). Compared with group S, the range of joint motion increased at time T1~T3 in group I, and the difference was statistically significant(P<0.05); the comfort scores of group I increased at time T1~T5, and the difference was statistically significant(P<0.05). Compared with group S, patients in group I got out of bed earlier after operation, the proportion of patients who needed rescue analgesia decreased, and the number of pressing analgesia pump within 48 hours after operation decreased, and the differences were statistically significant (P<0.05); there was no statistically significant difference in the incidence of postoperative nausea, vomiting, delirium and other adverse reactions between the two groups (P>0.05). Conclusions The analgesic effect of ultrasound-guided adductor canal combined with IPACK block is significantly better than that of adductor canal block alone in treating patients undergoing TKA. |
