术前股神经联合坐骨神经阻滞在胫腓骨骨折患者中的镇痛效果分析  

Analgesic Effect of Preoperative Femoral-Sciatic Nerve Block in Patients with Tibial and Fibular Fractures

作　　者：丰亮[1] 黄杰锋[1] 刘张玉 陈玲 Feng Liang;Huang Jiefeng;Liu Zhangyu;Chen Ling(Department of Anesthesiology,The Second People's Hospital of Nantong,Nantong 226000,China)

机构地区：[1]南通市第二人民医院麻醉科,江苏南通226000

出　　处：《巴楚医学》2025年第1期65-69,共5页Bachu Medical Journal

基　　金：南通市卫生健康委员会科研项目(MS2023068)。

摘　　要：目的:分析术前股神经-坐骨神经阻滞对胫腓骨骨折患者的临床疗效。方法:选择2021年12月1日—2023年12月1日于南通市第二人民医院行胫腓骨切开复位内固定术的患者60例,根据麻醉方式不同分为观察组(n=30)和对照组(n=30),观察组和对照组分别于手术前后行股神经-坐骨神经阻滞,将术后1天、3天、5天、7天标记为T_0、T_1、T_2、T_3,观察两组患者不同时间节点的视觉模拟量表(VAS)评分、认知功能评分以及围术期指标。结果:与对照组相比,观察组患者T_0、T_1、T_2、T_3活动和静息状态的VAS评分均明显降低、认知功能评分均显著升高。观察组患者苏醒时间[(9.38±1.93)min vs(16.86±3.78)min]、术中丙泊酚用量[(559.96±30.61)mg vs(657.75±28.82)mg]、术中瑞芬太尼用量[(516.42±35.96)μg vs(725.43±23.45)μg]、术后首次排气时间[(22.31±2.68)h vs(29.63±3.56)h]均明显小于对照组(均P<0.05)。结论:术前股神经-坐骨神经阻滞能够有效减轻胫腓骨骨折患者的术后疼痛,减少镇痛镇静药物的使用量,有利于术后认知功能及肠道功能恢复。Objective:To analyze the analgesic efficacy of preoperative femoral-sciatic nerve block on patients with tibial and fibular fractures.Methods:A total of sixty patients who underwent open reduction and internal fixation of the tibia and fibula at The Second People's Hospital of Nantong between December 1,2021,and December 1,2023,were selected and divided into an observation group(n=30)and a control group(n=30)based on different anesthesia methods.Both the observation and control groups received femoral-sciatic nerve block before and after surgery.The postoperative days 1,3,5,and 7 were marked as T0,T1,T2,and T3,respectively,to observe the visual analogue scale(VAS),cognitive function scores,and perioperative indicators at different time points for both groups.Results:Compared with the control group,the observation group showed significantly lower VAS scores and higher cognitive function in both active and resting states at T0,T1,T2,and T3.The awakening time[(9.38±1.93)min vs(16.86±3.78)min],intraoperative propofol dosage[(559.96±30.61)mg vs(657.75±28.82)mg],intraoperative remifentanil dosage[(516.42±35.96)g vs(725.43±23.45)g],and postoperative time to first flatus[(22.31±2.68)h vs(29.63±3.56)h]were all significantly less in the observation group than in the control group(all P<0.05).Conclusion:Preoperative femoral-sciatic nerve block can effectively alleviate postoperative pain in patients with tibial and fibular fractures,reduce the use of analgesic and sedative drugs,which is beneficial for postoperative cognitive and intestinal function recovery.

关 键 词：股神经-坐骨神经阻滞 胫腓骨骨折 术后疼痛 认知功能 

分 类 号：R683.42[医药卫生—骨科学]