Objective      To evaluate the effects of continuous femoral nerve block (CFNB) guided by ultrasound combined with nerve stimulator and patient-controlled intravenous analgesia (PCIA) for analgesia and

functional rehabilitation after total knee arthroplasty (TKA).       Methods      Totally 80 patients graded to ASA Ⅰ-Ⅲ scheduled for elective unilateral TKA were equally randomized into a CFNB group or a PCIA group. All patients received analgesia for 3 d. The visual analogue scale (VAS) scores at rest

active functional exercise (AFE) state and continuous passive movement (CPM) state were estimated

and the tramadol dose by intramuscular injection and the presses of the pump were recorded. Knee flexion angles at AFE on 24

48

and 72 h after TKA

time of first walk

daily walk times and the complication were observed. Patient satisfaction was compared.       Results      The VAS pain scores during rest

AFE and CPM on 4

8

12

24

36

and 48 h after TKA in CFNB group were significantly lower than those in PCIA group (

P

0.05). The presses of the pump and the tramadol dose by intramuscular injection were fewer in CFNB group than PCIA group (

P

0.05). Knee flexion angles at AFE in 24

48

and 72 h when the pain caused by exercise was mild or moderate (VAS8) in CFNB group were significantly larger than those in PCIA group (

P

0.05). Daily walk times of the patients in CFNB group were much more than those in PCIA group (

P

0.05). The patients in CFNB group needed significantly less time for first work than those in PCIA group (

P

0.05). The side effects in CFNB group were fewer than those in PCIA group. CFNB group showed significantly greater satisfaction with analgesia method (9.88±1.09) than PCIA group (8.60±1.17) (

P

0.05).       Conclusion      The patients who received CFNB guided by ultrasound united with nerve stimulator after TKA showed better pain relief

higher safety

less complications

better functional rehabilitation and higher patient satisfaction than those who received PCIA.