Application effect of femoral-sciatic nerve block in the total knee arthroplasty under gneral anesthesia in elderly patients

ObjectiveTo evaluate the effects of femoral-sciatic nerve block in the total knee arthroplasty(TKA) under general anesthesia in elderly patients.

MethodsSixty patients with single side TKA, more than 65 years, ASA Ⅰ or Ⅱand body mass index 18~25 kg/m², were randomly divided into the general anesthesia group(group G) and general anesthesia combined with nerve block group(group GNB) using a random number table(30 cases each group).Before anesthesia induction, the group GNB was dealed with femoral-sciatic nerve block in the affected side guided by ultrasound.The 20-25 mL and 15-20 mL of 0.5% ropivacaine were injected into the femoral nerve puncture point and sciatic nerve puncture point, respectively, and the total amount was less than 40 mL.Two groups were treated with postoperative patient controlled intravenous analgesia.The dosage of propofol and remifentanil per unit time in two groups was recorded.The incidence rates of postoperative nausea and vomiting(PONV) and postoperative delirium in two groups during postoperative 48 h were recorded.The 2 mg/kg tramadol was intravenously injected at VAS>3 scores, and the adding times of tramadol administrated in two groups were recorded.The satisfaction scores after 48 h of operation and time of hospitalization were recorded in two groups.

ResultsCompared with group G, the dosage of propofol and remifentanil decreased, and the incidence rate of PONV and satisfaction degree increased in group GNB(P < 0.05 to P < 0.01).There was no statistical significance in the time of hospitalization between two groups(P>0.05).

ConclusionsFemoral-sciatic nerve block shows a good postoperative analgesic effect in the TKA under general anesthesia in elderly patients, which can reduce the consumption of general anesthetics, decrease the incidence of PONV, and improve the patients' satisfaction.