目的 探讨全麻复合超声引导下腓肠神经阻滞麻醉在外踝关节骨折手术中的应用价值.方法 选取2020年5月至2023年10月在我院择期行外踝关节骨折手术治疗的120例患者,采用随机数字表法分为试验组和对照组各60例,两组均行常规术前准备及心电图监测.试验组采用全麻复合超声引导下的腓肠神经阻滞,对照组采用全麻复合超声引导下的胭窝坐骨神经阻滞,观察两组患者神经阻滞的麻醉操作时间,麻醉起效时间,麻醉持续时间,术后2、4、8、12、24 h的VAS评分,小腿肌力,术后24 hD-2聚体和下肢深静脉血管超声观察血栓并发症发生情况.结果 试验组麻醉操作时间、麻醉起效时间明显快于对照组(P＜0.05);试验组对小腿肌力无影响(P＜0.05);两组患者术后2、4、8、12、24 h的VAS评分,术后24 h D-2聚体差异均无统计学意义(P＞0.05),下肢深静脉血管超声均未发现血栓并发症发生.结论 相较于超声引导下坐骨神经阻滞,超声引导下的腓肠神经阻滞能促进外踝关节骨折手术患者术后尽早活动,加速康复,具有临床应用价值.
The application value of sural nerve block under general anesthesia combined with ultrasound guidance in external ankle fracture surgery
Objective To investigate the application value of sural nerve block under general anesthesia combined with ultrasound-guided in external ankle fracture surgery.Methods A total of 120 patients who underwent elective surgical treatment for external ankle fracture in our hospital from May 2020 to October 2023 were selected as study objects.The patients were divided into an experimental group and a control group by random number table method,60 in each group.Routine preoperative preparation and elec-trocardiogram monitoring were performed in both groups.The experimental group received sural nerve block under general anesthesia combined with ultrasound guidance.The control group received popliteal sciatic nerve block under general anesthesia combined with ul-trasound guidance.Anesthesia operation time,effective time of anesthesia,duration of anesthesia,VAS score at 2、4、8、12 and 24 hours after surgery and calf muscle strength were observed.D-2mer and lower limb deep vein ultrasound were used to observe the occurrence of thrombotic complications after 24 hours of surgery.Results The operation time and effective time of anesthesia in the ex-perimental group were significantly faster than those in the control group(P＜0.05).The experimental group had no effect on calf muscle strength(P＜0.05).The VAS scores at 2,4,8,12 and 24 h after surgery and D-2 polymers at 24 h after surgery were not sig-nificantly different between the two groups(P＞0.05).No thrombotic complications of lower limbs were found by deep venous ultra-sonography.Conclusions Compared with sciatic nerve block guided by ultrasound,sural nerve block can promote the early postoperative activity and accelerate the recovery in patients with external ankle fracture surgery.It has a clinical application value.
Ultrasonic guidanceSciatic nerve blockSural nerve blockExternal ankle fracture surgery
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