Objective To compare the early analgesic effects of continuous femoral nerve block analgesia (CFNB) and patient controlled intravenous analgesia (PCIA) and their effects on functional recovery after total knee arthroplasty.Methods Retrospective analysis was conducted on 60 ASA Ⅰ and ASA Ⅱ patients with unilateral total knee arthroplasty in our hospital from January 2014 to January 2015.The patients were divided into two groups,CFBN group (treatment group) and PCIA group (control group),with 30 patients in each group.VAS scores of postoperative ipsilateral knee resting and movement pain,range of postoperative knee joint motion (ROM),muscle strength of femoral quadriceps,incidence rates of adverse reaction within 7 days after operation,HSS score 3 months before and after the operation,and discharge time were observed.Results Postoperative VIS score in CFNB group was lower than that in PCIA group.ROM and muscle strength of femoral quadriceps in CFBN group were better than those in PCIA group on day 1,2,3,5,and 7 after the operation.Postoperative adverse reaction rate within 7 days in PCIA group was significantly higher than that in CFNB group.HSS score three months after the operation in CFNB group was higher than that in PCIA group.Discharge time of CFNB group was significantly earlier than that of PCIA group (P＜0.05).Conclusion Compared with PCIA analgesia,CFNB analgesia shows better analgesic effect.It can alleviate early knee joint pain after TKA,increase joint motion,significantly shorten the hospitalization time,promote joint exercises which are effective in functional rehabilitation,and decrease the incidence of adverse reactions like nausea and vomiting.

Objective:To explore the clinical value of cardiac MR (CMR) compression sensing (CS) ultrafast cine sequence in evaluating left and right ventricular systolic function by comparing with traditional segmented acquisition cine sequence (Seg).Methods:Twenty-seven patients with various heart disease were prospectively included. Seg, breath holding CS (bhCS) and free breathing CS (fbCS) covering the left and right ventricles using multi slices in short axis were performed in random order. Friedman test was used to evaluate the overall image quality (grade 1-5 score), blood pool myocardial signal ratio (BMC) and edge sharpness under different methods. Biventricular end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and left ventricular myocardial mass (Mass) were measured for all three methods. The agreements of the functional measurements between bhCS and Seg (gold standard), and between fbCS and Seg were analyzed by Bland-Altman, and the correlation test was performed.Results:Twenty-four patients with diagnostic images(overall image quality score≥2) for all three methods were included in further analysis. The total imaging time of Seg, bhCS and fbCS decreased successively[375.0 (332.0, 405.6) vs. 50.0 (47.8, 53.7) vs. 20.0 (17.8, 23.7) s, χ 2=48.00, P<0.001]. The overall image quality of fbCS was slightly lower than that of Seg ( Z=-2.67, P=0.023), and there was no difference between Seg and bhCS ( Z=-1.44, P=0.447), bhCS and fbCS ( Z=1.23, P=0.660). There were no differences in edge sharpness (χ 2=1.08, P=0.582) and BMC (χ 2=0.58, P=0.747) for three methods. Bland-Altman polts showed good agreement for biventricular functional measurements between bhCS and Seg, and between fbCS and Seg. All functional measurements of bhCS and fbCS were highly correlated with that of seg ( r>0.96, P<0.001). Conclusions:Compared with traditional sequences, CS ultrafast cine sequences can save scanning time and provide similar image quality. No matter whether breath holding or not, the cardiac functional results of CS sequence and traditional cine sequence have good agreement and high correlation.