Jun Dong1, Su Min2, Kai-Hua He2, Li-Hua Peng2, Jun Cao2, Wei Ran2. 1. Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, China. dongjun441@163.com. 2. Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, China.
Abstract
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.
RCT Entities:
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.
Authors: Imran Ahmed; Amit Chawla; Martin Underwood; Andrew J Price; Andrew Metcalfe; Charles Hutchinson; Jane Warwick; Kate Seers; Helen Parsons; Peter Dh Wall Journal: Cochrane Database Syst Rev Date: 2020-12-08
Authors: Imran Ahmed; Amit Chawla; Martin Underwood; Andrew J Price; Andrew Metcalfe; Charles E Hutchinson; Jane Warwick; Kate Seers; Helen Parsons; Peter D H Wall Journal: Bone Joint J Date: 2021-03-08 Impact factor: 5.082