Influence of ultrasound guided continuous adductor canal block combined with periarticular local infiltration on immune cells in patients undergoing total knee arthroplasty

doi:10.3877/cma.j.issn.1674-0785.2019.12.004

Abstract

Abstract:

Objective

To compare the perioperative immune function after ultrasound guided continuous adductor canal block (CACB) alone and CACB combined with periarticular local infiltration analgesia (PLIA) in patients undergoing total knee arthroplasty (TKA).

Methods

Sixty patients in Changzhi City People′s Hospital from June to December 2018 undergoing TKA under general anesthesia were randomly divided into either a CACB alone group or CACB combined with PLIA group (PLIA group), with 30 cases in each group. Blood samples were assessed for the proportions of CD3⁺ , CD4⁺ , and NK cells as well as CD4⁺ /CD8⁺ ratio before surgery (T1) and 2 h (T2), 12 h (T3), 24 h (T4), and 48 h (T5) after surgery.

Results

Compared with T1, the levels of CD3⁺ , CD4⁺ , CD4⁺ /CD8⁺ ratio, and NK cells declined significantly in both groups at all time points after surgery (P<0.05). Compared with the CACB group, the levels of CD3⁺ , CD4⁺ , CD4⁺ /CD8⁺ , and NK cells at T2-T4 in the PLIA group were significantly higher (P<0.05).

Conclusion

CACB combined with PLIA can more significantly reduce postoperative knee joint pain, relieve passive movement pain, shorten passive movement time, and promote the patients' early movement and function recovery by reducing the suppression of immune function.

Key words: Continuous adductor canal block, Immunity, cell, Arthroplasty, replacement, knee, Immune

Jialei Zhang, Min Guo, Guoping Wang, Yuanfu Han, Wenbin Zhang. Influence of ultrasound guided continuous adductor canal block combined with periarticular local infiltration on immune cells in patients undergoing total knee arthroplasty[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(12): 898-901.

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Figures/Tables 3

References 11

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组别	例数	年龄（岁，±s）	体质量指数（kg/m²，±s）	ASA分级（Ⅰ/Ⅱ）	手术时间（min，±s）	止血带使用时间（min，±s）
阻滞组	30	60±9	27±3	7/23	85±7	80±6
联合组	30	61±7	26±5	9/21	89±6	82±7
统计值	?	t=1.022	t=0.983	χ²=1.726	t=0.898	t=1.025
P值	?	0.508	0.556	0.443	0.501	0.457

组别	例数	年龄（岁，±s）	体质量指数（kg/m²，±s）	ASA分级（Ⅰ/Ⅱ）	手术时间（min，±s）	止血带使用时间（min，±s）
阻滞组	30	60±9	27±3	7/23	85±7	80±6
联合组	30	61±7	26±5	9/21	89±6	82±7
统计值	?	t=1.022	t=0.983	χ²=1.726	t=0.898	t=1.025
P值	?	0.508	0.556	0.443	0.501	0.457

组别		例数	T2	T3	T4	T5
静息状态		?	?	?	?	?
?	阻滞组	30	2.13±0.77	2.63±0.61	2.96±0.66	2.70±0.47
?	联合组	30	2.03±0.76	2.37±0.56	2.77±0.56	2.37±0.72
?	t值	?	0.287	1.514	0.849	1.873
?	P值	?	0.635	0.126	0.252	0.071
被动运动		?	?	?	?	?
?	阻滞组	30	3.27±0.74	5.47±1.19	6.07±1.08	4.90±1.15
?	联合组	30	3.10±0.88	4.10±0.71	5.23±1.10	3.87±1.13
?	t值	?	0.342	3.892	5.034	3.945
?	P值	?	0.311	<0.001	0.012	0.014

组别		例数	T2	T3	T4	T5
静息状态		?	?	?	?	?
?	阻滞组	30	2.13±0.77	2.63±0.61	2.96±0.66	2.70±0.47
?	联合组	30	2.03±0.76	2.37±0.56	2.77±0.56	2.37±0.72
?	t值	?	0.287	1.514	0.849	1.873
?	P值	?	0.635	0.126	0.252	0.071
被动运动		?	?	?	?	?
?	阻滞组	30	3.27±0.74	5.47±1.19	6.07±1.08	4.90±1.15
?	联合组	30	3.10±0.88	4.10±0.71	5.23±1.10	3.87±1.13
?	t值	?	0.342	3.892	5.034	3.945
?	P值	?	0.311	<0.001	0.012	0.014

组别	例数	时间	CD3^＋	CD4^＋	CD8^＋	CD4^＋/CD8^＋	自然杀伤细胞
联合组	30	T1	62.35±3.27	34.52±3.26	24.26±2.82	1.45±0.23	14.25±1.44
		T2	56.05±3.17^ab	32.61±3.69	23.25±2.62	1.42±0.24	12.35±2.32^a
		T3	53.75±3.64^ab	28.72±2.32^ab	21.85±2.77^a	1.35±0.22^a	10.36±1.42^a
		T4	55.46±6.03^ab	30.72±4.27^ab	22.37±3.68	1.32±0.15^a	11.91±1.83^a
		T5	57.72±6.38^a	33.25±3.62	23.41±3.28	1.39±0.22^a	12.17±1.29^a
阻滞组	30	T1	61.25±4.17	34.10±3.37	24.71±3.16	1.43±0.21	13.65±2.47
		T2	52.87±2.75^a	30.17±4.21^a	24.17±3.42	1.33±0.21	11.45±2.62
		T3	49.40±3.91^a	24.74±3.34^a	22.25±3.14	1.27±0.17^a	9.47±1.35^a
		T4	51.59±5.37^a	27.23±3.62^a	22.58±2.65	1.29±0.16^a	10.91±1.39^a
		T5	54.72±5.82^a	33.45±2.89	23.26±2.69	1.37±0.15	11.64±1.55^a

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