The evaluation and comparison of the effectiveness of analgesia practicesin the perioperative and postoperative period in patients undergoing total knee replacement in Akdeniz Üniversity hospital

The Evaluation and Comparison of the Effectiveness of Analgesia Practices in the Perioperative and Postoperative Period in Patients Undergoing Total Knee Replacement in Akdeniz University Hospital Purpose: Total knee replacement surgery (TKR), an operation with increasing incidence, is one of the most successful orthopedic operations, offering pain relief and functional improvement. The effective analgesic applications after the operation has vital advantages such as effective rehabilitation, prevention of chronic pain, maximization of joint range of motion, improvement of quadriceps function and minimisation of possible complications. The purpose of our study is to examine the anesthesia and analgesia methods practiced in our center in terms of parameters such as total opioid consumption, pain scores, length of hospital stay and improve the health service delivery in the light of the results of both our study and literature. Methods: The Perioperative / postoperative data of patients undergoing elective unilateral total knee replacement operation in Akdeniz University Medical Faculty Hospital, aged between 18-81, ASA (American Society of Anesthesiologists) classification I-III were examined prospectively and observationally. Results: When the patients were grouped according to whether or not PAI was performed, the pain scores of 6th, 12th, 24th and 48th hours at rest were significantly lower in the patients who underwent PAI, and there was no significant difference other than the 12th hour pain scores with passive movement. Again, significantly lower total post-op opioid consumption was observed in the PAI group. Apart from this, for parameters such as hospital stay time, 90 degree knee flexion time, first mobilization time, PAI was not found to be superior to other analgesic techniques. However, it was shown that there was a significant difference between groups in terms of nausea / vomiting and in an early rehabilitation criteria, time to positivity of straight leg raise test. Conclusion: In our study, we have seen that the use of regional analgesia techniques such as LIA and FB have dramatic advantages over general anesthesia and systemic opioid use, although they are not proven to have definite advantages among themselves. The quality of health services in our center will also be improved in the light of our study results and literature. Key Words: TKR, Periaticular Injection, Local Infiltration Analgesia