To observe the effects of multi-point injection around the knee joint in fast-track arthroscopic knee surgery.

In this prospective study, 60 patients who received arthroscopic knee surgery at Department of Orthopaedics of Third Hospital of Hebei Medical University from June 2016 to June 2019 were selected and divided into either an observation group or a control group using the random number table method according to the double-blind principle, with 30 patients in each group. Patients in both groups were given combined spinal epidural anesthesia in the lateral decubitus position. The observation group received analgesia injection around the knee joint, and the control group received multi-point injection of normal saline. Both groups were routinely treated with an intravenous self-controlled analgesia pump (PCIA) within 48 h after surgery. The effects, start time of functional exercise, satisfaction, and PCIA press times were compared between the two groups. The rest and movement visual analogue scale (VAS) scores were compared between the two groups at 4, 8, 12, and 24 h after surgery. The postoperative complications were compared between the two groups.

The excellent and good rate after treatment in the observation group was 93.33%, which was significantly higher than that of the control group (73.33%; χ²=4.320, P＜0.05). The time to first functional exercise and the time to ambulation were significantly shorter in the observation group than in the control group (t=11.478 and 13.884, respectively, P＜0.05). Postoperative analgesia satisfaction was significantly higher in the observation group than that in the control group (t=3.935, P＜0.05). The number of PCIA press times in the observation group was significantly less than that of the control group (t=15.492, P＜0.05). There was no significant difference in rest and movement VAS scores at 4 and 8 h after surgery between the two groups (P＞0.05). Rest and movement VAS scores at 12 and 24 h after operation in the observation group were significantly lower than those of the control group (P＜0.05). The total incidence of postoperative complications had no significant difference between the two groups (6.67% vs 10.00%; χ²=0.218, P＞0.05).

The effect of periarticular injection analgesia combined with PCIA is better than that of conventional intravenous PCIA, which is convenient and does not affect postoperative joint activity and functional exercise. It is more suitable for fast-track surgery and has clinical application value.