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Effects of the nontourniquet combined with controlled hypotension technique on pain and long-term prognosis in elderly patients after total knee arthroplasty: a randomized controlled study.
Journal of Anesthesia ( IF 2.8 ) Pub Date : 2019-08-19 , DOI: 10.1007/s00540-019-02671-z
Jun Dong 1 , Su Min 1 , Kai-Hua He 1 , Li-Hua Peng 1 , Jun Cao 1 , Wei Ran 1
Affiliation  

PURPOSE The aim of this study was to confirm the alleviating effects of the nontourniquet technique on the postoperative acute and chronic pain of patients after total knee arthroplasty (TKA). METHODS 122 elderly patients undergoing TKA were randomly divided into two groups: group T (n = 58) and group H (n = 64). An electronic inflatable tourniquet was used during TKA in group T. The patients in group H received controlled hypotension but without tourniquet use during the operation. The numeric rating scale (NRS) score was used to evaluate pain level on day 1, day 2, day 3 and day 7 after the operation, and the incidence of chronic pain was judged at 3-month and 1-year follow-ups, and functional recovery of the knee joint was estimated by the active range of knee joint motion (AROM) at the same time points. Cognitive function was assessed by the montreal cognitive assessment scale (MoCA) for 7 days after operation. RESULTS There were no significant differences in the NRS scores and AROM for 7 days after surgery. The incidence rate of chronic pain in group H (25.0%) was lower than that in group T (41.4%) and the AROM in group H was greater at one year follow-up. The MoCA score in group H was lower than that in group T on day 1 and day 2. CONCLUSION The nontourniquet combined with controlled hypotension technique can alleviate chronic pain and promote the long-term rehabilitation of patients after TKA.

中文翻译:

非止血带联合控制性降压技术对全膝关节置换术后老年患者疼痛和长期预后的影响:一项随机对照研究。

目的本研究的目的是证实非止血带技术对全膝关节置换术(TKA)术后患者急性和慢性疼痛的缓解作用。方法将122例接受TKA的老年患者随机分为两组:T组(n = 58)和H组(n = 64)。T组在TKA期间使用了电子充气止血带。H组的患者接受了控制性低血压,但在手术期间未使用止血带。使用数字评分量表(NRS)评分评估术后第1天,第2天,第3天和第7天的疼痛程度,并在3个月和1年的随访中判断慢性疼痛的发生率,并通过在相同时间点的膝关节活动范围(AROM)估算膝关节的功能恢复。术后7天通过蒙特利尔认知评估量表(MoCA)评估认知功能。结果术后7天NRS评分和AROM均无显着差异。H组慢性疼痛的发生率(25.0%)低于T组(41.4%),H组的AROM在随访一年时较高。结论H组的MoCA评分在第1天和第2天均低于T组。结论非止血带结合控制性降压技术可减轻TKA术后的慢性疼痛并促进患者的长期康复。0%)低于T组(41.4%),H组在一年随访时的AROM较高。结论H组的MoCA评分在第1天和第2天均低于T组。结论非止血带结合控制性降压技术可减轻TKA术后的慢性疼痛并促进患者的长期康复。0%)低于T组(41.4%),H组在一年随访时的AROM较高。结论H组的MoCA评分在第1天和第2天均低于T组。结论非止血带结合控制性降压技术可减轻TKA术后的慢性疼痛并促进患者的长期康复。
更新日期:2019-11-01
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