Comparing the effects of analgesia techniques with controlled intravenous and epidural on postoperative pain and knee rehabilitation after total knee arthroplasty
Aysun Yılmazlar, Merlin Bozkurt, Ömer Faruk Bilgen
Uludağ Üniversitesi Tıp Fakültesi 1Anesteziyoloji ve Reanimasyon Anabilim Dalı,
2Ortopedi ve Travmatoloji Anabilim Dalı, Bursa, Türkiye
Keywords: Total knee arthroplasty; postoperative analgesia; patient-controlled analgesia; intravenous; epidural.
Abstract
We aimed to compare the effects of controlled intravenous (iv.) and epidural analgesia techniques on postoperative analgesia and knee rehabilitation after total knee arthroplasty (TKA).
Patients and methods: After the approval of the ethical committee, both i.v. (group I.V; n=20) and epidural (group E; n=22) postoperative analgesia (PCA) were applied in 42 patients (range 18 to 75 years) undergoing TKA. Because of dislocation of epidural catheters in the postoperative period, two cases were excluded from the study and 20 patients in each group were evaluated. Postoperative pain was assessed with the visual analog scale (VAS) and it was recorded in the recovery unite and then at the 4th, 8th,12th, 16th, 24th, 48th and 72nd hours. The knee flexion angles of patients were daily measured with a goniometer. The data were analyzed using Mann Whitney U-test, two-samples independent t-test, Fisher exact-chi squared and Pierson chi squared tests.
Results: Demographic variables were similar in two groups. In group E, VAS scores at rest and motion were found to be significantly lower and knee flexion angles were significantly higher than that of the group I.V.
Conclusion: We determined that epidural PCA provided better pain relief and rehabilitation than iv. PCA in postoperative period after TKA.