New progress of pain management after total knee arthroplasty

Abstract

Background The postoperative pain after total knee arthroplasty(TKA) is the main reason to affect the early postoperative function exercise of the knees. Postoperative analgesia is a challenging task for medical personnel because it requires not only good analgesia effect, but also a minimal impact on joint movement function. The regional anesthesia techniques provides a good direction for the management of postoperative pain. Objective To introduce the advantages and risks of various regional pain management after TKA and review the new research advances to provide new clues for pain management after TKA. Content Femoral nerve block(FNB) provides effective postoperative analgesia for patients recovering from TKA. Whether using the sciatic nerve block additionally as the clinical treatment method or not is still in disputation. Lumbar epidural block can obviously increase the incidence of epidural hematoma in orthopedic patients. Femoral nerve block can provide a similar effect and greater satisfaction. In the meantime, comparing with the epidural pain management, it also can obviously reduce the risk of adverse reactions occurrence. Local infiltration analgesi(LIA) and adductor canal block have hope to get enough pain control and with fewer side effects. Trend LIA management and adductor canal block may replace FNB as pain management after TKA, but it still need further clinical trials to verify current results. Key words: Total knee arthroplasty; Analgesia; Regional analgesia