关键词: 全膝关节置换术, 坐骨神经阻滞, 局部局部浸润麻醉

Abstract: ［Abstract］ Objective To compare the difference of postoperative analgesic effects after total knee replacement between the sciatic nerve block and the periarticular local infiltration anesthesia around the joint. Methods Thirty-three patients with total knee surgery，ASA class Ⅰ or Ⅱ，were divided into sciatic nerve block groups（SNB group，n=16，the patients were given 20 ml of 0.375% ropivacaine for sciatic nerve block）；local infiltration anesthesia group （LIA group，n=17，the patients were given mixed local anesthetics including 150 ml of 0.2% of ropivacaine，100 mg of tramadol and 0.5 mg of epinephrine for periarticular local infiltration anesthesia. The VAS scores in the static state and the active state were recorded and evaluated at 2，8，16，24，36 and 48 hours postoperatively. Postoperative nausea and vomiting，the symptoms of local anaesthesia poisoning，the occurrence of rashes，and the status of KSS scores in the two groups were observed. Results Compared with the SNB group，static VAS scores of LIA group was higher at postoperative 2，8，16 hours，with statistically significant differences （P<0.01），but the scores were reduced at postoperative 24，36 and 48 hours，with statistically significant differences （P<0.01）. Compared with the SNB group，motional VAS scores of LIA group was higher at postoperative 2 and 8 hours，with statistically significant differences（P<0.01）， but the scores were reduced at postoperative 16，24，36 and 48 hours，with statistically significant differences（P<0.01）. The two groups of patients were similar in postoperative nausea and vomiting，the symptoms of anesthetic poisoning，rash occurrence，and KSS score，without statistically significant differences. Conclusion SNB or LIA can provide good postoperative analgesic effect for total knee surgery，but the latter is more suitable for such operations from the perspective of convenient procedures.

Key words: total knee replacement, sciatic nerve block, local infiltration anesthesia