[Effect of Femoral and Sciatic Nerve Block on Tourniquet Reaction and Postoperative Pain during Total Knee Arthroplasty].

Objective: To observe the effect of femoral and sciatic nerve block on tourniquet reaction and postoperative pain during total knee arthroplasty (TKA).

Methods: Totally 60 patients scheduled for TKA were equally divided into two groups according to the random number table (n=30):femoral nerve block (F) group and femoral and sciatic nerve block (SF) group. The changes of mean arterial pressure (MAP) and heart rate (HR) in each group were recorded at the tourniquet inflated immediately (T1),30 minutes (T2),60 minutes (T3),90 minutes (T4),loose tourniquet (T5) and post extubation (T6). The total amount of anesthetics drugs propofol and remifentanil were calculated. The pain score after extubation and the location of pain were recorded.

Results: MAP and HR in group SF were steady at T1-T6 (all P>0.05). Compared with group SF,MAP in group F were significantly increased at T2-T4 and T6 (all P<0.05),and the HR at T4 and T6 were significantly increased (all P<0.05). Compared with the group F,the total amount of propofol and remifentanil were significantly decreased in group SF (all P<0.05),and pain scores at rest and on movement were reduced (P<0.05);in addition,90% patients in group F complained of posterior popliteal pain.

Conclusion: Femoral nerve and sciatic nerve block applied in TKA can obviously inhibit the tourniquet reaction,keep hemodynamic stability,reduce the dosage of anesthetic drug,and relieve the postoperative pain.