Analgesic effect of continuous gastrocnemius plane block after foot and ankle surgery
Objective To explore the analgesic effect of continuous gastrocnemius plane block for postoperative pain management in foot and ankle surgery.Methods Forty-two patients undergoing foot and ankle surgery under general anesthesia were enrolled,including 19 males and 23 females,aged 18-64 years,BM1 18-28 kg/m2,ASA physical status Ⅰ-Ⅲ.Patients were randomly divided into two groups:the continuous gastrocnemius plane block group(group CN)and the patient controlled intravenous analgesia(PCIA)group(group Ⅰ),21 patients in each group.In group CN,continuous gastrocnemius plane block was performed with a 0.125％ropivacaine solution,totaling 300 ml.The background infusion rate was set at 3 ml/h,with a bolus dose of 8 ml and a lockout time of 25 minutes for analgesia,while in group Ⅰ,patients received PCIA with oxycodone,utilizing a formulation comprising oxycodone 30 mg and tropisetron 6 mg in a total volume of 150 ml.The infusion rate was set at 0.5 ml/h,with a single additional dose of 5 ml.The ar-ea under the curve(AUC)of numeric rating scale(NRS)scores was calculated during the postoperative periods of 0-16,16-24,24-48,and 0-48 hours for both rest and activity states in both groups.NRS scores were evaluated at 1,8,16,24,32,and 48 hours postoperatively during both rest and activity in the two groups.Postoperative recovery time for the tibial nerve and common peroneal nerve was assessed in group CN,titration of oxycodone,cumulative morphine-equivalent usage of rescue analgesics within 48 hours postoperatively,number of rescue analgesia administrations,rescue analgesia rate,the time of the first ambulation,the incidence of postoperative nausea and vomiting,and patient satisfaction score in both groups.Results Compared with group Ⅰ,group CN exhibited a significant reduction in AUC of NRS scores during the periods of 0-16,16-24,24-48,and 0-48 hours for both rest and activity(P＜0.01).Compared with group Ⅰ,group CN showed significantly lower NRS scores at rest and during activity 1,8,16,24,32,and 48 hours postoperatively(P＜0.01).In group CN,10 patients(50％)had recovery of common peroneal nerve motor function at 16 hours,17 patients(85％)at 24 hours,and all patients had re-covery at 32-48 hours for the common peroneal nerve,and within 48 hours,all patients had normal tibial nerve motor function.Compared with group Ⅰ,group CN showed significantly reduced cumulative morphine-equivalent consumption and rescue analgesia times(P＜0.01),with a significantly lower rescue analgesia rate(P＜0.01),and significantly increased patient satisfaction scores(P＜0.01).There were no statisti-cally significant differences between the two groups in oxycodone titration,time of first ambulation,and inci-dence of nausea and vomiting.Conclusion Ultrasound-guided continuous gastrocnemius plane block can a-chieve the separation of tibial nerve motor and sensory blockade,providing effective and sustained analgesia for postoperative pain management after foot and ankle surgery.
Continuous gastrocnemius plane blockPopliteal sciatic nerve blockPostoperative analgesiaFoot and ankle surgery
万方数据
维普
