Efficacy of intravenous parecoxib combined with femoral nerve block for postoperative analgesia and knee functional rehabilitation in elderly patients following total knee replacement
10.37601cma.j.issn.0254-1416.2011.08.007
- VernacularTitle:静脉注射帕瑞昔布联合股神经阻滞用于老年病人膝关节置换术后镇痛及膝关节功能康复的效果
- Author:
Hongmei ZHOU
;
Shengmei ZHU
- Publication Type:Journal Article
- Keywords:
Cyclooxygenase inhibitors;
Femoral nerve;
Nerve block;
Arthroplasty,replacement,knee;
Pain,postoperative;
Analgesia
- From:
Chinese Journal of Anesthesiology
2011;31(8):929-931
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the efficacy of intravenous parecoxib combined with femoral nerve block on postoperative analgesia and knee functional rehabilitation in elderly patients following total knee replacement.MethodsForty elderly patients with osteoarthritis schedu[ed for total knee arthroplasty under general anesthesia,aged 65-74 years,weighing 45-90 kg,ASA [Ⅱ,were randomly divided into two groups( n = 20 each).FNB group received femoral nerve blockade for postoperative analgesia ( local injection of 0.25 % ropivacaine 25 ml at the end of surgery,repeated every 8 h up to 72 h after surgery).FNB-Pa group received the femoral nerve blockade plus the parecoxib (administered Ⅳ bolus of 40 mg 30 min before the end of surgery,12,24,and 48 h after surgery respectively).Pain was scored at rest or during continuous passive motion using Visual Analog Scale (VAS).The Hospital for Special Surgery (HSS) knee score was determinated before surgery,at 24,48 and 72 h after surgery respectively.Side effects were also recorded in both groups.Results VAS score was significantly lower at rest and during continuous passive motion in FNB-Pa group than in FNB group ( P < 0.05).Compared with baseline value,HSS score increased significantly during postoperative analgesia in both groups( P < 0.05 or 0.01 ).HSS score were significantly higher at 48 h and 72 h after surgery in FNB-Pa group than in FNB group ( P < 0.05).No severe related side effects occured in both groups.ConclusionFemoral nerve block in combination with intravenous parecoxib can safely and effectively relieve the static and dynamic pain after total knee replacement and is helpful for rehabilitation of the prosthesis knee joint function after surgery.