Effect of Femoral Nerve Block with Different Concentrations of Chloroprocaine on the Recovery of Joint Function in Rehabilitation Training after Knee Replacement: A Prospective, Double-Blind, Randomized, Controlled Clinical Study

Abstract

Background: Patients who undergo total knee arthroplasty (TKA) experience severe pain after surgery. Especially active pain in early postoperative rehabilitation training of the knee joint is particularly severe, and it should receive people’s attention.Methods: A total of 90 patients who only received unilateral TKA in our hospital were randomly and equally divided into three groups (group C1: 1% chloroprocaine, group C2: 2% chloroprocaine, and group NS: 0.9% sodium chloride solution 0.2 ml/kg; the dosage was fixed at 0.2 ml/kg for all three groups). All patients received femoral nerve catheterization before TKA and started rehabilitation training 48 h after TKA. The visual analogue scale (VAS) scores of active exercises before and after administration were observed and recorded. VAS scores, maximum knee flexion and extension angles, the incidence of knee flexion angle ≥100° in each group, the American knee society(AKS) scores, together with postoperative rehabilitation training satisfaction and adverse effects were recorded at 7 days and 3 months after surgery.Results: Compared with the NS group, VAS scores after administration of patients in the group C1 and C2 were decreased significantly at each time point (P < 0.05), and the maximum knee flexion angles were increased significantly (P < 0.05), as well as the proportion of maximum knee angle ≥100° (P < 0.05). The postoperative rehabilitation training satisfaction of patients in group C1 and C2 were more than that of patients in the NS group (P < 0.05).Conclusion: The administration of 1% chloroprocaine for femoral nerve block before rehabilitation training after TKA could improve the knee flexion angle at the early postoperative stage, increase the proportion of patients who could squat, and cause fewer side effects.