超声引导下隐神经阻滞用于胫腓骨骨折手术的麻醉效果研究  

Study on the anesthetic effect of ultrasound-guided saphenous nerve block in surgery for tibia-fibula fracture

作　　者：单小娟 SHAN Xiao-juan(Department of Anesthesiology,Jiangyan Hospital of Traditional Chinese Medicine,Taizhou 225500,China)

机构地区：[1]江苏省泰州市姜堰中医院麻醉科,225500

出　　处：《中国现代药物应用》2025年第3期117-120,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨超声引导下隐神经阻滞用于胫腓骨骨折手术的麻醉效果。方法选择胫腓骨骨折患者64例为研究对象,根据麻醉方式分为对照组(32例,腰硬联合麻醉)和观察组(32例,超声引导下隐神经阻滞麻醉)。比较两组患者麻醉时间,术后疼痛数字评分法(NRS)评分,自控静脉镇痛泵使用情况,不良反应发生情况。结果观察组感觉阻滞起效时间(5.86±2.54)min、运动阻滞起效时间(8.14±2.37)min均比对照组的(11.92±3.05)、(20.59±2.45)min短,感觉阻滞维持时间(453.78±9.35)min、运动阻滞维持时间(346.83±8.15)min均比对照组的(301.30±4.15)、(218.52±5.40)min长(P<0.05)。术后2、6、12、24、48h,观察组患者活动时NRS评分分别为(2.35±1.04)、(2.89±0.13)、(3.25±0.16)、(2.27±0.29)、(2.02±0.24)分,静息时NRS评分分别为(2.25±0.18)、(2.01±0.06)、(1.96±0.02)、(1.74±0.13)、(1.68±0.05)分;对照组患者活动时NRS评分分别为(2.90±0.05)、(3.23±0.06)、(3.81±0.05)、(3.19±0.72)、(2.95±0.16)分,静息时NRS评分分别为(2.63±0.20)、(2.40±0.12)、(2.29±0.05)、(2.07±0.21)、(2.10±0.17)分。观察组患者术后2、6、12、24、48h活动时和静息时NRS评分均低于对照组(P<0.05)。观察组自控静脉镇痛泵有效按压次数(5.36±2.15)次多于对照组的(3.19±1.07)次,开启时间(80.12±14.52)min短于对照组的(172.05±20.75)min,麻醉药物追加量(3.82±1.47)ml少于对照组的(7.19±2.50)ml(P<0.05)。观察组与对照组不良反应发生率分别为6.25%、3.13%,比较差异无统计学意义(P>0.05)。结论超声引导下隐神经阻滞用于胫腓骨骨折手术中,起效时间短,麻醉维持时间长,且术后患者疼痛程度低,安全性高,值得临床推广。Objective To explore the anesthetic effect of ultrasound-guided saphenous nerve block in surgery for tibia-fibula fracture.Methods 64 patients with tibia-fibula fracture were selected as study subjects and divided into control group(32 cases,combined spinal-epidural anesthesia)and observation group(32 cases,ultrasound-guided saphenous nerve block anesthesia).The duration of anesthesia,numerical rating scale(NRS)score,use of patient-controlled intravenous analgesia and occurrence of adverse reactions were compared between the two groups.Results The onset time of sensory and motor block were(5.86±2.54)and(8.14±2.37)min in the observation group,which were shorter than(11.92±3.05)and(20.59±2.45)min in the control group;the maintenance time of sensory and motor block were(453.78±9.35)and(346.83±8.15)min in the observation group,which were longer than(301.30±4.15)and(218.52±5.40)min in the control group(P<0.05).At 2,6,12,24 and 48 h after operation,the NRS scores during movement of the observation group were(2.35±1.04),(2.89±0.13),(3.25±0.16),(2.27±0.29)and(2.02±0.24)points,and the NRS scores at rest were(2.25±0.18),(2.01±0.06),(1.96±0.02),(1.74±0.13)and(1.68±0.05)points;the NRS scores during movement of the control group were(2.90±0.05),(3.23±0.06),(3.81±0.05),(3.19±0.72)and(2.95±0.16)points,and the NRS scores at rest were(2.63±0.20),(2.40±0.12),(2.29±0.05),(2.07±0.21)and(2.10±0.17)points.The NRS scores of the observation group were lower than those of the control group at 2,6,12,24 and 48 h after operation(P<0.05).In the observation group,the effective compressions of the patient-controlled intravenous analgesia was(5.36±2.15)times,which was more than(3.19±1.07)times in the control group;the turn-on time was(80.12±14.52)min,which was shorter than(172.05±20.75)min in the control group;the supplemental dose of anesthetic drug was(3.82±1.47)ml,which was less than(7.19±2.50)ml in the control group(P<0.05).The incidence of adverse reactions in the observation group and the control group w

关 键 词：胫腓骨骨折 超声引导下隐神经阻滞 术后镇痛 疼痛程度 不良反应 

分 类 号：R614[医药卫生—麻醉学]