Research progress of oxidative stress in the pathogenesis and treatment of diabetic complications

• Published in: Zhongguo lin chuang yan jiu Vol. 38; no. 6; pp. 836 - 840
• Main Author: ZHOU Dalei，YUAN Jing，HAN Chaoyong，YOU Lanying，XU Jin，LIU Dandan，HUANG Luxin，HUANG Junjie，YUAN Yu，SUN Jie，ZHENG Kang
• Format: Journal Article
• Language: Chinese; English
• Published: The Editorial Department of Chinese Journal of Clinical Research 01.06.2025
• Subjects: adductor canal catheterization; arthritis; continuous adductor canal block; postoperative analgesia; quadriceps femoris muscle strength; total knee arthroplasty; ultrasound ⁃guided
• DOI: 10.13429/j.cnki.cjcr.2025.04.005
• ISSN: 1674-8182

Objective To study the effects of ultrasound -guided proximal continuous adductor canal block (ACB) and mid - segment continuous ACB on postoperative pain and muscle strength of quadriceps femoris in elderly patients undergoing total knee arthroplasty (TKA) . Methods Eighty elderly patients scheduled for elective TKA under general anesthesia at Zhongda Hospital Southeast University from October 2022 to December 2023 were selected and randomly divided into two groups according to the random number table method：the ultrasound - guided proximal ACB group (group P，n = 40) and the ultrasound-guided mid-segment ACB group (group M，n = 40) . Catheters were placed under ultrasound guidance in both groups for continuous nerve block when patients were transferred to anesthesia resuscitation room after the end of the operation. The observation indicators included postoperative resting state Visual analogue scale (VAS) score，activity state VAS score，quadriceps femoris muscle strength，range of motion of the knee joint，cumulative dose of local anesthetic ropivacaine，remedial analgesia，postoperative nausea and vomiting，postoperative hospital stay，and the occurrence of complications of continuous nerve block. The main observation time points were immediately after catheter placement (T0) ，4 hours postoperatively (T1) ，8 hours postoperatively (T2) ，24 hours postoperatively (T3) ，48 hours postoperatively (T4) ，and 72 hours postoperatively (T5) . Results The postoperative resting state VAS scores and activity state VAS scores of patients in both groups showed a trend of change over time (P <0.01) . At time point T3，the quadriceps femoris muscle strength［ (54.7 ± 20.6) kg vs (67.5 ± 28.4) kg］and the total dose of ropivacaine［ (205.8 ± 33.7) mL vs (223.6 ± 42.5) mL］in group P were lower than those in group M，with statistically significant differences (P < 0.05) , the range of motion of the knee joint in group P［ (68.9 ± 7.9) ° vs (65.2 ± 8.5) °］was slightly higher than that in group M，but the difference was not statistically significant (P > 0.05) . Conclusion Ultrasound - guided proximal continuous ACB has a significantly better analgesic effect on activity pain 24 hours after TKA in elderly patients compared with mid - segment continuous ACB. It can significantly reduce the dosage of ropivacaine，but decrease the muscle strength of the quadriceps femoris.