超声引导前路坐骨神经和股神经阻滞在膝关节以下骨折手术中的应用

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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.

Key words： ultrasound sciatic nerve femoral nerve block

Received: 30 November 2015

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	Articles by authors
	Wang Quanguang
	CHEN Limei
	LIU Le
	SHI Kejian
	ZHANG Xuezheng
	XU Xuzhong.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2016/V46/I11/818

[1] NEEDOFF M, RADFORD P, COSTIGAN P. Local anesthesia for postoperative pain relief after foot surgery: a prospective clinical trial[J]. Foot Ankle Int, 1995, 16(1): 11-13.
[2] 李挺, 金勉, 徐旭仲, 等. 腰丛-坐骨神经阻滞应用于老年病人的下肢手术[J]. 温州医学院学报, 2005, 35(5): 376-378.
[3] Murray J M, Derbyshire S, Shields M O. Lower limb blocks [J]. Anaesthesia, 2010, 65 Suppl 1(1): 57-66.
[4] Ota J, Sakura S, Hara K, et al. Ultrasound-guided anterior approach to sciatic nerve block: a comparison with the posterior approach[J]. Anesth Analg, 2009, 108(2): 660-665.
[5] Casati A, Baciarello M, Di Cianni S, et al. Effectsm of ultrasound guidance on the minimum effective anaesthetic volume required to block the femoral nerve[J]. Br J Anaesth, 2007, 98(6): 823-827.
[6] Davarci I, Tuzcu K, Karcioglu M, et al. Comparison between ultrasound-guided sciatic-femoral nerve block and unilateral spinal anaesthesia for outpatient knee arthroscopy[J]. J Int Med Res, 2013, 41(5): 1639-1647.
[7] Van Elstraete A C, Poey C, Lebrun T, et al. New landmarks for the anterior approach to the sciatic nerve block: imaging and clinical study[J]. Anesth Analg, 2002,95(1): 214-218.
[8] Gelfand H J, Ouanes J P, Lesley M R, et al. Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis[J]. J Clin Anesth, 2011, 23(2): 90-96.
[9] Abrahams M S, Aziz M F, Fu R F, et al. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials[J]. Br J Anaesth, 2009, 102(3): 408-417.
[10] Dolan J. Ultrasound-guided anterior sciatic nerve block in the proximal thigh: an in-plane approach improving the needle view and respecting fascial planes[J]. Br J Anaesth, 2013, 110(2): 319-320.
[11] Lin E, Choi J, Hadzic A. Peripheral nerve blocks for outpatient surgery: evidence-based indications[J]. Curr Opin Anaesthesiol, 2013, 26(4): 467-474.
[12] Saranteas T. Limitations in ultrasound imaging techniques in anesthesia: obesity and muscle atrophy?[J]. Anesth Analg, 2009, 109(3): 993-994.
[13] 王权光, 陈丽梅, 刘乐, 等. 超声引导下连续股神经阻滞联合单次前路坐骨神经阻滞用于膝关节置换术后镇痛[J]. 温州医学院学报, 2013, 43(12): 792-795.