Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial".

BACKGROUND

Postoperative pain is an important complication that impedes the functional recovery of the total knee arthroplasty (TKA). A variety of analgesic methods including the popliteal artery and capsule of the posterior knee block (IPACK), local infiltration analgesia (LIA) and peripheral cutaneous nerve (PCN) block have been applied via intraoperative or postoperative local injection for alleviating pain after TKA. The purpose of this study was to compare the analgesic effect and function outcome of two local anesthetic methods for reducing postoperative pain after TKA.

METHODS

We demonstrated the effect of these two methods on postoperative pain, need for additional analgesics, functional recovery, and pain-related secreted proteins.

RESULTS

One hundred twenty patients aged 50-75 years who underwent TKA for osteoarthritis between December 2021 to June 2024 were included in the study and divided into two groups as follows: Group A was given local anesthetic drug by IPACK combined with LIA; Group B was given the same local anesthetic drug formulation by IPACK combined with a novel PCN block. The visual analog scale (VAS) values, the need for additional analgesics and the expression of pain-related proteins in the Group B were lower than in the Group A on postoperative 6 h, 1, 2 and 3 days (P < 0.05). However, the joint ROM and early ambulation in the Group B were significantly higher than in the Group A on postoperative 1, 2 and 3 days (P < 0.05).

CONCLUSIONS

Based on the present evidence, patients treated with IPACK combined with new PCN block method can effectively reduce pain after TKA compared to IPACK combined with LIA. Furthermore, this approach not only mitigates postoperative pain but also decreases the need for postoperative analgesics and enhances patient's functional recovery.

TRIAL REGISTRATION

NCT05202730, Date: 05/12/2021.