Ren Yongcheng, Liao Jiacai, Qin Xiaoyan, Yang Jianming
Department of Anesthesiology.
Department of Ophthalmology and Otorhinolaryngology, Qianjiang District Chinese medicine hospital of Chongqing, Chongqing, China.
Medicine (Baltimore). 2020 May;99(20):e20213. doi: 10.1097/MD.0000000000020213.
Effective postoperative analgesia may enhance early rehabilitation after total knee arthroplasty (TKA). The purpose of this study is to perform a randomized controlled trial to compare the efficiency of adductor canal block (ACB) with periarticular infiltration (PAI) versus PAI alone for early postoperative pain treatment after TKA.
After institutional review board approval, written informed consent was obtained from patients undergoing elective TKA. Subjects were randomized into 2 groups as follows: adductor canal blockade with 30 mL of 0.5% ropivacaine and 100 mcg of clonidine. All patients received a periarticular infiltration mixture intraoperatively with scheduled and patient requested oral and IV analgesics postoperatively for breakthrough pain. The primary outcome was morphine consumption in the first 24 hours. Secondary outcomes included pain scores, morphine consumption at 48 hours, opioid-related side effects (post-operative nausea/vomiting, sedation scores), functional outcomes, quadriceps strength, and length of hospital stay.
For the present trial, we hypothesized that patients receiving adductor canal block + PAI would have significantly lower morphine consumption and pain scores after surgery.
researchregistry5490.
有效的术后镇痛可能会促进全膝关节置换术（TKA）后的早期康复。本研究的目的是进行一项随机对照试验，比较收肌管阻滞（ACB）联合关节周围浸润（PAI）与单纯PAI用于TKA术后早期疼痛治疗的效果。
经机构审查委员会批准后，获得接受择期TKA患者的书面知情同意书。将受试者随机分为2组，如下：用30毫升0.5%罗哌卡因和100微克可乐定进行收肌管阻滞。所有患者术中均接受关节周围浸润混合液，并在术后根据计划和患者需求给予口服和静脉镇痛药以缓解爆发性疼痛。主要结局是术后24小时内的吗啡消耗量。次要结局包括疼痛评分、48小时时的吗啡消耗量、阿片类药物相关副作用（术后恶心/呕吐、镇静评分）、功能结局、股四头肌力量和住院时间。
对于本试验，我们假设接受收肌管阻滞+PAI的患者术后吗啡消耗量和疼痛评分会显著降低。
researchregistry5490。
