经皮穴位电刺激疗法对固定平台单髁置换术后早期疼痛影响的临床研究OA

Objective:To observe the effect of transcutaneous electric acupoint stimulation(TEAS)on early pain after fixed-bearing unicompartmental knee arthroplasty(FB-UKA).Methods:From May 2023 to May 2024,60 patients with medial compartment knee osteoar-thritis were randomly divided into 2 groups,with 30 cases in each group.All patients were treated with FB-UKA.Within 7 days after surgery,the routine analgesia group received routine multimodal analgesia,while the acupoint electric stimulation group received TEAS analgesia in addition to the routine multimodal analgesia regimen.Both groups were given additional tramadol hydrochloride for analgesia when necessary.Visual analogue scale(VAS)scores of knee joint rest and motion pain and Hospital for Special Surgery(HSS)knee scores were evaluated before surgery and at 12 hours and 1,3,5 and 7 days after surgery;at 4 weeks after surgery,the forgotten joint score(FJS)was evaluated.Meanwhile,the time of first use of tramadol hydrochloride after surgery,the total consumption of tramadol hydrochloride within 7 days after surgery,and the occurrence of gastrointestinal reactions were recorded.Results:①General information.One patient in the acu-point electric stimulation group developed allergy to acupoint electric stimulation patch during the first postoperative treatment and withdrew from the trial;one patient in the routine analgesia group developed deep vein thrombosis of the lower limb after surgery and withdrew from the trial;finally,29 cases were included in each group.②VAS score of knee joint rest pain.There was no interaction effect between time factor and grouping factor(F=0.518,P=0.762).The VAS score of knee joint rest pain showed a trend of increasing first and then decrea-sing with time,and there was a time effect(F=81.321,P=0.000).The VAS score of knee joint rest pain in the acupoint electric stimula-tion group was lower than that in the routine analgesia group(F=24.335,P=0.000).③VAS score of knee joint motion pain.There was no interaction effect between time factor and grouping factor(F=1.000,P=0.427).The VAS score of knee joint motion pain showed a trend of increasing first and then decreasing with time,and there was a time effect(F=63.941,P=0.000).The VAS score of knee joint motion pain in the acupoint electric stimulation group was lower than that in the routine analgesia group(F=16.688,P=0.000).④HSS knee score.The HSS knee scores of both groups showed a trend of decreasing first and then increasing with time(F=1 690.819,P=0.000;F=1 578.109,P=0.000).Except for pre-surgery(t=1.263,P=0.212),the HSS knee scores of the acupoint electric stimulation group at 12 hours and 1,3,5,and 7 days after surgery were higher than those of the routine analgesia group(t=2.829,P=0.006;t=7.130,P=0.000;t=5.866,P=0.000;t=3.943,P=0.000;t=3.753,P=0.000).⑤FJS.At 4 weeks after surgery,the FJS of the acupoint electric stimulation group was higher than that of the routine analgesia group(t=5.609,P=0.000).⑥Additional use of postoperative analgesics.All patients additionally used tramadol hydrochloride for analgesia after surgery.The time of first use after surgery in the acupoint electric stimulation group was later than that in the routine analgesia group(t=5.055,P=0.000),and the consumption of tramadol hydrochloride within 7 days after surgery was less than that in the routine analgesia group(t=-3.477,P=0.001).⑦Incidence of gastrointestinal reac-tions.During the trial,2 patients in the acupoint electric stimulation group developed gastrointestinal reactions such as nausea and vomiting,and 8 patients in the routine analgesia group developed gastrointestinal reactions,all of which were relieved after antiemetic and stomach-protecting treatments.The incidence of gastrointestinal reactions in the acupoint electric stimulation group was lower than that in the routine analgesia group(x2=4.350,P=0.037).Conclusion:The application of TEAS on the basis of routine multimodal analgesia can effectively relieve early pain after FB-UKA,reduce the use of analgesic drugs and the resulting gastrointestinal reactions,contribute to the recovery of knee joint function,and its effect is better than that of routine multimodal analgesia alone.