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目的：探讨膝关节周围局麻药物注射联合静脉自控镇痛泵（PCIA）在全膝关节置换（TKA）术后镇痛的临床效果。方法2012年5月~6月，选择全身麻醉下膝关节骨性关节炎单侧TKA患者40例，随机分为研究组20例和对照组20例：研究组缝合伤口前关节局部注射0.5%罗哌卡因20ml+地塞米松10mg混合液；对照组局部注射等体积生理盐水，两组患者术后均应用静脉镇痛泵，持续使用48h。采用视觉类比评分法（VAS）评估术后两组患膝活动痛，记录术后4、8、12、24、48h的VAS评分，患者总体满意度及恶心、呕吐等不良反应。结果研究组术后4、8、12、24、48h，患膝活动时VAS评分小于对照组，差异有统计学意义（P＜0.01）；总体满意度明显高于对照组，差异有统计学意义（P＜0.01）；两组不良反应发生率低。结论膝关节周围局麻药物注射联合静脉自控镇痛泵多模式镇痛可明显减轻 TKA术后早期疼痛，镇痛效果满意，有利于术后早期膝关节活动、促进功能康复。“,”Objective To investigate the ef iciency of pain management post total knee arthroplasty (TKA) by periarticular local anesthetic injection combined patient-control ed intravenous analgesia (PCIA). Methods:From May 2012 to June 2012, 40 cases with unilateral knee osteoarthritis performed TKA under general anesthesia were included in this study. 40 cases were randomly divided into test group (20 knees) and a control group (20 knees). In the study group, compounds of 0.5%ropivacaine 20ml+dexamethasone 10mg were injected periarticular before the wound closure; while in the control group the same volume of normal saline were injected in similar method. Both groups underwent intravenous analgesia pump for 48h post TKA. Mobile visual analog score (VAS) at 4,8,12,24,48 hours post surgery, patient satisfaction and overal nausea, vomiting and other adverse reactions were recorded and analyzed. Results The study group had lower mobile VAS score at 4,8,12,24,48 hours post TKA than the control group (P<0.01). The overal satisfaction ratio was significantly higher and the adverse reactions were lower compared with the control group (P<0.01). Conclusion Periarticular local anesthetic injection combined intravenous analgesia pump can significantly reduce early mobile pain post TKA;it is benefit for early knee joint activities to promote functional recovery.