The aim of this study was to observe the effects of posterior femoral cutaneous nerve block combined with sciatic and saphenous nerve block compared with sciatic and saphenous nerve block alone on postoperative posterior side of the knee (popliteal fossa) pain and sleep quality in patients with TKA, and to further alleviate postoperative posterior side of the knee pain in patients with TKA and improve the quality of postoperative sleep.
Patients who are >45 years of age; intended to undergo elective first TKA under general anesthesia
ASA grade II-III.
Agreed to participate in this study and signed the informed consent form.
BMI less than 28Kg/m2.
Patients who refuse to participate in the trial
Preoperative inability to communicate due to speech and hearing impairment, etc.
History of allergy to local anesthetics or opioids
Contraindications to nerve block operation.
Parallel
Posterior Femoral Cutaneous Nerve Combined With Proximal Sciatic and Saphenous Nerve Block
Procedure/SurgeryAll nerve blocks were performed under ultrasound guidance，single supragluteal approach sciatic nerve block using a nerve stimulator, 20 ml of drug was injected around the sciatic nerve, the extent of drug diffusion was observed, the needle tip was turned into the deep surface of the gluteus maximus muscle below the deep gluteal artery and 5 ml of drug was injected, followed by a retractile canal saphenous nerve block injected with 15 ml of drug, and the difference in sensation of the posterior thighs of the bilateral thighs was measured after 15 min to ensure posterior femoral cutaneous nerve were blocked
Simple Sciatic and Saphenous Nerve Blocks
Procedure/SurgeryAll nerve blocks were performed under ultrasound guidance，single subgluteal approach sciatic nerve block using a nerve stimulator, with 25 ml of drug injected around the sciatic nerve, followed by a retractile canal saphenous nerve block with 15 ml of drug injection
Postoperative anteroposterior and posterior knee Visual Analogue Scale scores (passive motion/resting)
The level of pain at the knee surface incision and on the posterior side of the knee at rest and motion was asked and recorded using the Visual Analogue Scale scores at postoperative hour 1 (before the patient left the PACU), postoperative hour 6, postoperative hour 24, and postoperative hour 48, respectively (0 for no pain and 10 for the most severe pain imaginable)
Postoperative night sleep time
Use of exercise bracelets to record actual hours of patient sleep
Earliest time on the ground
Length of time between the end of surgery and the patient's active movement off the floor
Amount of remedial opioid use
Total remedially applied opioids within 48 hours of surgery
Number of patient PCNA uses
Number of times a patient presses the PCNA in the 48 hours postoperatively
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