Application of ultrasound-guided anterior approach to sciatic nerve block and femoral nerve block for patients with fracture surgery below the knee joint
Wang Quanguang, CHEN Limei, LIU Le, SHI Kejian, ZHANG Xuezheng, XU Xuzhong.
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015
Wang Quanguang,CHEN Limei,LIU Le, et al. Application of ultrasound-guided anterior approach to sciatic nerve block and femoral nerve block for patients with fracture surgery below the knee joint[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(11): 818-821,825.
Abstract：Objective: To compare the clinical effects of anesthesia and postoperative analgesia for patients with below-knee fracture surgery between ultrasound-guided anterior approach to sciatic nerve block combined with femoral nerve block and epidural anesthesia. Methods: Sixty patients undergoing below-knee surgery were randomly divided into two groups, group A (n=30) and group B (n=30). Patients in group A underwent ultrasound-guided anterior approach to sciatic nerve block combined with femoral nerve block. Patients in group B underwent epidural anesthesia. The onset time, duration of sensory block and operation time were recorded. Visual analogue scales (VAS) were used to score the pain intensity during anesthesia operation of the swing position and 48 h postoperatively. The mean arterial pressure and heart rate were measured in the perioperative period. The time of first foodintake of patients after operation , the side effects (vomiting, pruritus and urinary retention) within 48 h postoperatively and satisfaction intensity of patients were also noted. Results: The duration of sensor nerve block of femoral nerve and sciatic nerve was longer in Group A. The nerve block group also reduced the pain intensity during position changes for anesthesia. The mean arterial pressure was decreased more significantly in group B at the time of 15 min, 30 min and 45 min after anesthesia. Group A significantly decreased urinary retention incidence (P<0.05) and the time of first food-intake (P<0.001). Conclusion: For patients with below-knee fracture surgery, ultrasound-guided anterior approach to sciatic nerve block combined with femoral nerve block can provide better intraoperative and postoperative pain control, fewer complications and improve the overall patient satisfaction.
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