Abstract: Objective To study effects of analgesic effect and muscle strength recovery of different concentrations of ropivacaine sciatic nerve combined with femoral nerve block for patients with total knee arthroplasty(TKA).
Methods 95 patients with TKA from April 2018 to November 2019 were divided into Group A(31 cases),Group B(32 cases) and Group C(32 cases).All patients given 20 ml 0.4% ropivacaine femoral nerve block,Group A given 20 ml 0.35% ropivacaine sciatic nerve block,Group B given 20 ml 0.37% ropivacaine sciatic nerve block,Group C given 20 ml 0.4% ropivacaine sciatic nerve block.Then RVAS,IVAS,quadriceps femoris muscle strength,anaesthesia induced adverse reactions were compared between three groups.
Result 6h,12h,24h,36h after operation,RVAS of Group A was higher than that of Group B and Group C,RVAS of Group B was higher than that Group C(P<0.05).24h,36h after operation,IVAS of Group A was higher than that Group B and Group C,IVAS of Group B was higher than that Group C(P<0.05).h,12h,24h,36h after operation,muscle strength score of Group A was higher than that Group B and Group C,muscle strength score of Group B was higher than that Group C(P<0.05).There were significant difference in the recovery time of quadriceps femoris between Group A,Group B and Group C[(8.65±1.12)h vs (20.12±2.24)h vs (24.36±2.56)h](P<0.05).There were no significant difference in adverse reactions between Group A,Group B and Group C(35.48% vs 31.25% vs 37.50%)(P>0.05).
Conclusion 0.375% ropivacaine sciatic nerve combined with femoral nerve block anesthesia can ensure satisfactory analgesic effect,which is conducive to the recovery of muscle strength in patients with TAK.

Key words: total knee arthroplasty, nerve block, ropivacaine, analgesia, muscle strength