Objectives: To investigate the effect of flurbiprofen axetil combined with “cocktail” therapy on opioid dosage in patients after total knee arthroplasty (TKA). Methods: The clinical data of 200 patients who underwent TKA in Baoding No.1 Central Hospital hospital from March 2019 to March 2021 were collected for retrospective analysis. All 200 patients were divided into two groups according to their intraoperative anesthesia methods: the control group (100 cases) and the experimental group (100 cases). Patients in the control group were treated with “cocktail” therapy intraoperatively, while those in the experimental group were treated with flurbiprofen axetil combined with “cocktail” therapy intraoperatively. The hip pain scores in resting state and motion state were compared between the two groups at different postoperative time points, and postoperative pain relief, adverse reactions, and patient satisfaction with analgesia were statistically analyzed to evaluate the postoperative quality of life of the patients. Results: A statistically significant difference was observed in the intergroup and temporal effects of pain scores in resting state and motion state between the two groups (p<0.05). By comparison at each time point, the pain scores in the experimental group were significantly lower than those in the control group at the time point T1-T6 in resting and motion states, with a statistically significant difference (p<0.05). The frequency and dosage of remedial medication per capita in the experimental group were significantly lower than those in the control group, with a statistical significance (p<0.05). There was no significant difference in the scores of life quality items between the two groups preoperatively (p>0.05), while the scores of each item in the experimental group were significantly higher than those in the control group postoperatively (p<0.05). The satisfaction degree of the experimental group was significantly higher than that of the control group, showing a statistically significant difference (p<0.05). Conclusions: Flurbiprofen axetil combined with “cocktail” therapy is a safe treatment regimen that can improve the quality of life and safety of patients. With such a regimen, postoperative pain of patients undergoing TKA can be effectively relieved, and the use of opioids can be reduced. doi: https://doi.org/10.12669/pjms.38.3.4735 How to cite this:Wang L, Wu L, Han Z, Ma W, Geng Z. Effect of flurbiprofen axetil combined with “Cocktail” therapy on opioid dosage in patients after total knee arthroplasty. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4735 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background Multimodal analgesic regimens are well known as the best option for total knee arthroplasty. They include the adductor canal block, combined with local infiltration analgesia and a block of the interspace between the popliteal artery and the capsule of the posterior knee. However, these analgesic techniques all require a large amount of local anesthetics. In this study, we explored whether the quantity of local anesthetics could be decreased by using dexmedetomidine for the adductor canal block. Material/Methods Fifty-four patients scheduled for unilateral, primary total knee arthroplasty were allocated into 2 groups: the ropivacaine group (group R) and the dexmedetomidine group (group RD). Ropivacaine 0.5% was chosen as the initial concentration, and the concentration was decreased or increased according to the response of the previous participant. Based on Dixon’s up-and-down method, the median effective concentration was calculated. Results The quadriceps strength was similar between the 2 groups, both at 30 min after adductor canal block and during recovery from general anesthesia in the Postanesthesia Care Unit. None of the patients in this study exhibited bradycardia or hypotension. The median effective concentration of ropivacaine for adductor canal block was 0.29% (95% confidence interval [CI], 0.28–0.31%) in group RD, which was lower than that in group R (0.38% [95% CI, 0.36–0.41%]). Conclusions This study found perineural dexmedetomidine 1 μg/kg could reduce the median effective concentration of ropivacaine for the adductor canal block.

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Objectives: To identify the precise position of adductor canal; and to determine median effective volume (EV 50 ) for adductor canal block (ACB) by ultrasound.