Effects of General Anesthesia in Combination with Saphenous Nerve Block-Tibial Nerve Block on Analgesia for Total Knee Arthroplasty and Hemodynamic Indexes.
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Abstract
Purpose of the study: We aimed to assess the effects of general anesthesia (GA) plus saphenous nerve block-tibial nerve block (SNB-TNB) on analgesia for total knee arthroplasty (TKA) and hemodynamic indexes.
Material and methods: A control group and an observation group were set for equal allocation of 106 patients with knee osteoarthritis (KOA) treated with TKA during November 2021 and November 2023 through a random number table. GA was used for the control group, and GA plus SNB-TNB was performed for the observation group. Clinical indexes, analgesic effect, joint motion range, hemodynamic indexes and safety were compared between the two groups.
Results: The observation group had decreased fentanyl dosage, patient-controlled intravenous analgesia pump pressing times, morphine dosage, extubation time, and recovery time compared with those of the control group (P<0.05). The static and dynamic Visual Analog Scale scores at different time points were lower in the observation group than in the control group (P<0.05). The observation group had higher maximum flexion degree than that of the control group at different time points (P<0.05). The incidence rate of adverse reactions in the observation group was lower than that of the control group (P<0.05).
Discussion: SNB-TNB can comprehensively intervene with the tissues surrounding the knee joint, and nerve block techniques are capable of intercepting harmful inputs in a targeted manner, elevating pain threshold, inhibiting signaling transmission from nerve endings, and thus terminating the pain perception ability of the cortex. Nerve block mainly depends on local anesthesia, and is helpful for lowering the additional dose of opioids and maintaining the hemodynamic stability.
Conclusions: Compared with simple GA, GA plus SNB-TNB applied in TKA is more conducive to accelerating the recovery of patients, reducing the anesthetic dosage, enhancing the analgesic effect, with more stable hemodynamics and higher safety.
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