跟骨骨折术后镇痛中超声引导下连续坐骨神经阻滞的应用及对患者术后并发症发生的影响  

Application of continuous sciatic nerve block under ultrasound guidance during calcaneal fracture analgesia and its effect on postoperative complications

作　　者：张秀平[1] ZHANG Xiuping(Department of Anesthesiology,Third People′s Hospital of Zigong City,Zigong,Sichuan 643020,China)

机构地区：[1]四川省自贡市第三人民医院麻醉科,643020

出　　处：《重庆医学》2021年第S02期60-63,共4页Chongqing medicine

摘　　要：目的探究跟骨骨折术后镇痛中超声引导下连续坐骨神经阻滞的应用及对患者术后并发症发生的影响。方法选取2019年2月至2020年2月该院收治的行跟骨骨折切开复位内固定术的患者142例,依据方案区为对照组、研究组,各71例。对照组采用静脉自控镇痛,研究组采用超声引导下连续坐骨神经阻滞,比较两组的VAS评分、NRS评分以及并发症、血清PGE2指标变化情况,并进行评估、分析。结果研究组术后2、4、8、24、48 h静止痛、运动痛评分、VAS评分、血液PGE2均低于对照组(P<0.05);研究组并发症发生率8.4%少于对照组46.5%(P<0.05)。结论采用超声引导下连续坐骨神经阻滞,可降低患者的疼痛感、改善病灶处关节恢复情况,且并发症明显减少,通过联合方式给予镇痛,效果较好,值得在临床中推广。Objective To investigate the application of ultrasound-guided continuous sciatic nerve block in postoperative analgesia of calcaneal fractures and its effect on postoperative complications.Methods A total of 142 patients who underwent calcaneal fracture incision and internal fixation in our hospital from February 2019 to February 2020 were selected as the control group and the study group,with 71 cases in each group.The control group performed intravenous self-controlled analgesia,and the study group performed ultrasound-guided continuous sciatic nerve block.The two groups were compared for VAS score,NRS score,complications,and changes in serum PGE2 indicators for evaluation and analysis.Results The scores of resting pain and exercise pain at 2h,4h,8h,24h,and 48h after the study group were lower than those of the control group(P<0.05);2h(1.2±0.9),4h(2.0±1.4),The VAS scores at 8h(2.4±1.9),24h(2.2±1.8),and 48h(1.4±1.1)were lower than those in the control group(1.9±1.2,5.3±2.3,6.9±3.3,6.1±3.0,2.3±1.3)(P<0.05);the incidence of complications in the study group was 8.4%less than the control group 46.5%(P<0.05);the study group was 2h(85.6±2.6),4h(90.9±3.1),8h(96.3±1.9),24h after surgery(97.7±1.9)and 48h(98.5±1.7)blood PGE2 indexes were lower than those in the control group(86.5±2.0,92.7±3.1,97.7±1.4,105.6±2.9,108.2±2.6).Conclusion In the postoperative analgesia of patients with calcaneal fractures,continuous sciatic nerve block under ultrasound guidance can reduce the patient′s pain and improve the joint recovery at the lesion.The complications are significantly reduced.It has good pain and good effect,and it is worthy of great promotion and application in clinic.

关 键 词：跟骨骨折 术后镇痛 超声引导 坐骨神经阻滞 并发症 

分 类 号：R47[医药卫生—护理学]