Effects of multimode analgesia on acute pain after total knee arthroplasty and influence factors

Objective Objective To explore the status and influencing factors of acute pain control in patients after total knee arthroplasty under multimode analgesia, and to provide basis for pain management. Methods From June 2017 to June 2018, the patients who were diagnosed with knee osteoarthritis in the department of orthopedics of the Lanzhou University Second Hospital and who were to undergo total knee arthroplasty, age 40~80 years and with clear consciousness, were selected by handy sampling method. A total of 200 patients were included after excluding patients with pain caused by other diseases and severe heart, liver and kidney diseases. General information questionnaire was used 24 h before surgery; 24 h, 48 h and 72 h after surgery, pain scale was used to measure the degree of pain. The Houston pain scale was used to investigate the postoperative acute pain control 72 h after surgery. Pain control status, pain degree, age, body mass index(BMI), numbers of years of pain, analgesics, duration of analgesics, knee function score and preoperative psychological data were described by(±s), and t test was used for comparison between the two groups; gender, education level, labor intensity, previous pain history, cartilage injury degree were expressed as percentage, and chi-square test was used for comparison between the two groups. Results All the patients hoped to control the postoperative pain within the mild range. The mean pain score 72h after the surgery was (3.2±0.8), and the patient still had moderate pain in the acute phase. Subjects were less satisfied with pain control education. The patients had acute pain were significantly older in age(t=7.392, P<0.05), had larger BMI(t=6.214, P<0.05), longer duration of analgesic use(t=7.392, P<0.05), higher intensity of preoperative pain(t=1.321, P<0.05), higher degree of cartilage injury(χ2=0.519, P<0.05), more remarkable pain belief and perception(t=2.121, P<0.05) and catastrophic pain (t=1.103, P<0.05). Logistic regression showed that BMI, pain intensity during preoperative activities, degree of cartilage injury and pain disaster could significantly affect the control of postoperative acute pain. Conclusion The acute pain following TKA can be relieved obviously under multimode analgesia. BMI, pain intensity during preoperative activities, degree of cartilage damage and pain catastrophic can significantly affect the control of postoperative acute pain. Key words: Arthroplasty, replacement, knee; Acute pain; Risk factors