Effectiveness of Pain Control in Total Knee Arthroplasty between Different Anesthetic Techniques in Phrae Hospital

Main Article Content

Sawika Pinyo

Abstract

Background: Anesthetic techniques in total knee arthroplasty (TKA) include general anesthesia (GA), spinal anesthesia (SA), adductor canal block (ACB), periarticular infiltration (PAI) and SA combined with intrathecal morphine (SA+MO). There is diversity of utilizing these techniques.


Objective: To evaluate the efficacy of postoperative pain control and walking ability between different anesthetic techniques used in TKA.


Material and method: A retrospective analytical study was conducted among 153 patients receiving TKA during August 2018 – July 2019 under 5 different anesthetic techniques; group 1: SA+ACB 55 cases, group 2: SA+PAI 13 cases, group 3: SA+MO 63 cases, group 4: GA+PAI/ACB 9 cases and group 5: GA 13 cases. Postoperative pain score at 2, 24, 48 hours and ability to walk with walker within 48 hours were compared between groups.


Result: The mean 2-hrs pain score in GA group was 4.5 (SD 2.2), significantly higher than group 1−4. The average 24-hrs pain score in GA group was 4.3 (SD 2.0), significantly higher than group 1, 3 and 4. At 48 hours, the mean pain
score in GA group (3.5, SD 1.3) was higher than SA+ACB (2.6, SD 0.9, p=0.035) and GA+PAI/ACB group (2.1, SD 0.6, p=0.012). The pain scores in group 1−4 were not significantly different, no matter when assessed at 2, 24 or 48 hours. Percentages of patients with satisfied walking ability in SA+ACB and SA+PAI groups were higher than those of GA+PAI/ACB and GA groups (92.7% and 92.3% vs 55.6% and 53.8% respectively, p=0.002)


Conclusion: Using PAI or ACB, combined with either SA or GA provided similar effectiveness of postoperative pain control in TKA, and not different from SA+ MO. Combination of these techniques had better results than using GA alone.

Article Details

How to Cite
Pinyo, S. (2022). Effectiveness of Pain Control in Total Knee Arthroplasty between Different Anesthetic Techniques in Phrae Hospital. Lampang Medical Journal, 43(1), 26–32. Retrieved from https://he01.tci-thaijo.org/index.php/LMJ/article/view/255417
Section
Original Article

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