Ge Mei, Zhai Xiao-Jun, Li Yong
Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou 311200, Zhejiang, China.
Zhongguo Gu Shang. 2021 Aug 25;34(8):750-4. doi: 10.12200/j.issn.1003-0034.2021.08.011.
To evaluate the efficacy of adductor canal block (ACB) combined with transcutaneous electrical acupoint stimulation (TEAS)for postoperative analgesia and early functional exercise after total knee arthroplasty (TKA).
A total of 84 patients underwent primary unilateral TKA from January 2019 to August 2020 were selected, including 45 males and 39 females, aged 66-77 (72.8±8.9) years;body mass index (BMI) was for 19-25 (23.6±3.5) kg /m. They were divided into adductor canal block combined with transcutaneous electrical acupoint stimulation group (TEAS+ACB group)and simple adductor canal block group (ACB group) according to random number table method, 42 cases in each group. ACB was performed in ACB group during the operation. And TEAS was performed in TEAS+ACB group on bilateral lower limbs in 1-7 days postoperative on the basis of ACB. VAS scores at 6, 12, 24, 48, 72 h after surgery, knee function at 1, 2, 3, 7 days after surgery, knee motion at 7 days after surgery and length of hospitalization days were recorded and compared between the two groups.
There were no significant differences in VAS of rest pain and activity pain in postoperative 6, 12 h between two groups (>0.05), but the VAS of TEAS+ACB group was lower at 24, 48, 72 h after surgery(<0.05). There was no significant difference in at 1 day postoperatively between two groups(>0.05) , but the knee function of TEAS+ACB group was better than that of the ACB group in 2, 3, 7 days postoperatively (<0.05). The length of hospitalization days in were less than in ACB group. On the 7th day after operation, the knee motion of TEAS+ACB group was greater than that of the ACB group (<0.05).
TEAS combined with ACB has a better postoperative analgesic efficacy than simple ACB, and can promote early functional exercise of patients. It is safe and effective for postoperative analgesia after TKA.
评估收肌管阻滞(ACB)联合经皮穴位电刺激(TEAS)用于全膝关节置换术(TKA)术后镇痛及早期功能锻炼的疗效。
选取2019年1月至2020年8月行初次单侧TKA的84例患者,其中男45例,女39例,年龄66 - 77(72.8±8.9)岁;体重指数(BMI)为19 - 25(23.6±3.5)kg/m²。按随机数字表法分为收肌管阻滞联合经皮穴位电刺激组(TEAS + ACB组)和单纯收肌管阻滞组(ACB组),每组42例。ACB组于手术中实施ACB。TEAS + ACB组在ACB基础上于术后1 - 7天对双下肢实施TEAS。记录并比较两组术后6、12、24、48、72 h的视觉模拟评分(VAS)、术后1、2、3、7天的膝关节功能、术后7天的膝关节活动度及住院天数。
两组术后6、12 h静息痛和活动痛VAS比较,差异无统计学意义(>0.05),但TEAS + ACB组术后24、48、72 h的VAS较低(<0.05)。两组术后1天膝关节功能比较,差异无统计学意义(>0.05),但TEAS + ACB组术后2、3、7天膝关节功能优于ACB组(<0.05)。TEAS + ACB组住院天数少于ACB组。术后第7天,TEAS + ACB组膝关节活动度大于ACB组(<0.05)。
TEAS联合ACB较单纯ACB术后镇痛效果更佳,能促进患者早期功能锻炼。对TKA术后镇痛安全有效。