Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”

Abstract Background Postoperative pain is an important complication that impedes the functional recovery of the total knee arthroplasty (TKA). A variety of analgesic methods including the popliteal artery and capsule of the posterior knee block (IPACK), local infiltration analgesia (LIA) and periphe...

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Main Authors: Weilong Diwu, Wenhao Tang, Ming Yan, Wenrui Ma, Huifa Xu, Qiang Sun, Yisheng Han, Yi Wang, Chen Wang, Dawei Zhang, Long Bi, Min Yang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03182-z
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author Weilong Diwu
Wenhao Tang
Ming Yan
Wenrui Ma
Huifa Xu
Qiang Sun
Yisheng Han
Yi Wang
Chen Wang
Dawei Zhang
Long Bi
Min Yang
author_facet Weilong Diwu
Wenhao Tang
Ming Yan
Wenrui Ma
Huifa Xu
Qiang Sun
Yisheng Han
Yi Wang
Chen Wang
Dawei Zhang
Long Bi
Min Yang
author_sort Weilong Diwu
collection DOAJ
description Abstract Background Postoperative pain is an important complication that impedes the functional recovery of the total knee arthroplasty (TKA). A variety of analgesic methods including the popliteal artery and capsule of the posterior knee block (IPACK), local infiltration analgesia (LIA) and peripheral cutaneous nerve (PCN) block have been applied via intraoperative or postoperative local injection for alleviating pain after TKA. The purpose of this study was to compare the analgesic effect and function outcome of two local anesthetic methods for reducing postoperative pain after TKA. Methods We demonstrated the effect of these two methods on postoperative pain, need for additional analgesics, functional recovery, and pain-related secreted proteins. Results One hundred twenty patients aged 50–75 years who underwent TKA for osteoarthritis between December 2021 to June 2024 were included in the study and divided into two groups as follows: Group A was given local anesthetic drug by IPACK combined with LIA; Group B was given the same local anesthetic drug formulation by IPACK combined with a novel PCN block. The visual analog scale (VAS) values, the need for additional analgesics and the expression of pain-related proteins in the Group B were lower than in the Group A on postoperative 6 h, 1, 2 and 3 days (P < 0.05). However, the joint ROM and early ambulation in the Group B were significantly higher than in the Group A on postoperative 1, 2 and 3 days (P < 0.05). Conclusions Based on the present evidence, patients treated with IPACK combined with new PCN block method can effectively reduce pain after TKA compared to IPACK combined with LIA. Furthermore, this approach not only mitigates postoperative pain but also decreases the need for postoperative analgesics and enhances patient’s functional recovery. Trial registration NCT05202730, Date: 05/12/2021.
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spelling doaj-art-b24e4b2adc3145f0afd1a3a2d3aa6aca2025-08-20T04:01:35ZengBMCBMC Anesthesiology1471-22532025-07-012511910.1186/s12871-025-03182-zEfficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”Weilong Diwu0Wenhao Tang1Ming Yan2Wenrui Ma3Huifa Xu4Qiang Sun5Yisheng Han6Yi Wang7Chen Wang8Dawei Zhang9Long Bi10Min Yang11Department of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Anesthesiology and Perioperative Medicine, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Anesthesiology and Perioperative Medicine, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityDepartment of Orthopedics, Xijing Hospital of The Fourth Military Medical UniversityAbstract Background Postoperative pain is an important complication that impedes the functional recovery of the total knee arthroplasty (TKA). A variety of analgesic methods including the popliteal artery and capsule of the posterior knee block (IPACK), local infiltration analgesia (LIA) and peripheral cutaneous nerve (PCN) block have been applied via intraoperative or postoperative local injection for alleviating pain after TKA. The purpose of this study was to compare the analgesic effect and function outcome of two local anesthetic methods for reducing postoperative pain after TKA. Methods We demonstrated the effect of these two methods on postoperative pain, need for additional analgesics, functional recovery, and pain-related secreted proteins. Results One hundred twenty patients aged 50–75 years who underwent TKA for osteoarthritis between December 2021 to June 2024 were included in the study and divided into two groups as follows: Group A was given local anesthetic drug by IPACK combined with LIA; Group B was given the same local anesthetic drug formulation by IPACK combined with a novel PCN block. The visual analog scale (VAS) values, the need for additional analgesics and the expression of pain-related proteins in the Group B were lower than in the Group A on postoperative 6 h, 1, 2 and 3 days (P < 0.05). However, the joint ROM and early ambulation in the Group B were significantly higher than in the Group A on postoperative 1, 2 and 3 days (P < 0.05). Conclusions Based on the present evidence, patients treated with IPACK combined with new PCN block method can effectively reduce pain after TKA compared to IPACK combined with LIA. Furthermore, this approach not only mitigates postoperative pain but also decreases the need for postoperative analgesics and enhances patient’s functional recovery. Trial registration NCT05202730, Date: 05/12/2021.https://doi.org/10.1186/s12871-025-03182-zTotal knee arthroplastyPostoperative painLocal anesthesiaCutaneous nerve blockFunctional recovery
spellingShingle Weilong Diwu
Wenhao Tang
Ming Yan
Wenrui Ma
Huifa Xu
Qiang Sun
Yisheng Han
Yi Wang
Chen Wang
Dawei Zhang
Long Bi
Min Yang
Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”
BMC Anesthesiology
Total knee arthroplasty
Postoperative pain
Local anesthesia
Cutaneous nerve block
Functional recovery
title Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”
title_full Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”
title_fullStr Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”
title_full_unstemmed Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”
title_short Efficacy of Peripheral Cutaneous Nerve (PCN) on postoperative pain and functional outcome after total knee arthroplasty: a single-blind, randomized controlled clinical trial”
title_sort efficacy of peripheral cutaneous nerve pcn on postoperative pain and functional outcome after total knee arthroplasty a single blind randomized controlled clinical trial
topic Total knee arthroplasty
Postoperative pain
Local anesthesia
Cutaneous nerve block
Functional recovery
url https://doi.org/10.1186/s12871-025-03182-z
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