Ｏｂｊｅｃｔｉｖｅ　To investigate the effects of ischemic preconditioning (IPC) on the early recovery of patients after total knee arthroplasty (TKA).　Methods　A total of 40 patients [American Society of Anesthesiologists(ASA) Stage Ⅰ, Ⅱ] initially undergoing unilateral TKA after general anesthesia were randomly divided into two groups (n=20): an IPC group (group I) and a control group (group C). Group I underwent three cycles of 5 min ischemia/5 min reperfusion after induction of anesthesia, while group C received no treatment. After surgery, patient-controlled intravenous analgesia (PCIA) was performed, with 4 μg/kg sufentanil and 12 mg tropisetron in normal saline to 200 ml, at a background infusion rate of 2 ml/h. The PCA pump was set up with a bolus dose of 0.5 ml within a lockout interval of 15 min for 72 h. Sufentanil was used for rescue analgesia to maintain the Visual Analogue Scale (VAS) score≤3. The VAS scores of both groups were recorded 12, 24, 48 h and 72 h after surgery. The numbers of attempts and successful press times within 72 h were recorded. The use of sufentanil within 72 h was recorded, while the per capita dose of sufentanil and rescue analgesia rate was calculated. The scores of patient satisfaction 72 h after operation was recorded, while the number of straight leg raise and the range of spontaneous activity 1, 3, 7, 14 d after surgery were also recorded.　Results　No significant differences were detected in VAS between the two groups 12, 24, 48 h and 72 h after surgery (P>0.05). Compared with group C, group I presented remarkable decreases in the numbers of attempts and successful delivered doses, the average sufentanil dose and rescue analgesia rate (P<0.05), marked increased patient satisfaction scores (P<0.05) and reduced incidence of postoperative nausea and vomiting (P<0.05). Compared with group C, group I presented remarkable increases in the number of straight leg raise 1, 3, 7 d after surgery and the range of spontaneous activity 1, 3, 7, 14 d after surgery (P<0.05) , despite no significant differences were detected between the two groups in the straight leg raise 14 d after surgery (P>0.05).　Conclusions　IPC can effectively relieve postoperative pain and promote knee functional recovery, so as to improve early recovery quality.