超声引导连续坐骨神经阻滞用于足部手术术后镇痛

Application of continuous sciatic nerve block guided by ultrasound for postoperative analgesia after foot surgery

目的观察超声引导连续坐骨神经阻滞用于足部手术术后镇痛的临床效果。方法选择跟骨或外踝骨折患者20例,在腰麻下行切复内固定术后,随机被分为连续坐骨神经阻滞(CSB)组和患者自控静脉镇痛(PCIA)组,每组10例。记录术后静息和运动时的VAS评分、不同时段吗啡用量、患者满意度和不良反应等指标。结果CSB组在术后静息和运动时VAS评分都显著低于PCA组(P<0.05或P<0.01);CSB组各时间段吗啡用量及吗啡总量少于PCA组(P<0.01)。CSB组患者镇痛满意度优于PCA组(P<0.05)。结论超声引导下的连续坐骨神经阻滞能有效缓解足部、踝部手术术后疼痛,减少阿片类镇痛药物使用量,提高患者舒适度。

Objective To observe the clinical efficacy of ultrasound-guided continuous sciatic blocks for postoperative analgesia after foot surgery. Methods Twenty patients undergoing selective orthopedic foot surgery under spinal anesthesia were randomly assigned to either a continuous sciatic block group（CSB） or patient-controlled intravenous analgesia group（PCIA） with 10 cases each. The visual analogue scale（VAS） pain scores at still and on movement, patient＇s satisfaction, adverse effects and opioid requirements were recorded during analgesia. Results VAS scores at still and on movement were lower in group CSB than those in group PCIA（P〈0.05 or P〈0.01）. Postoperative opioid consumption over 48 h was lower in group CSB than that in group PCIA（P〈0.01）. The patients in group CSB were more satisfied than those in group PCIA （ P〈 0.05 ）. Conclusion Ultrasound-guided continuous sciatic blocks can relieve postoperative pain and decrease the need of opioids after foot surgery.