超声引导下肢神经阻滞和腰麻用于踝部手术的效果对比分析

Comparative Analysis of the Effect of Ultrasound-guided Lower Limb Nerve Block and Spinal Anesthesia for Ankle Surgery

目的对比在踝部手术中应用超声引导下肢神经阻滞与腰麻治疗的作用。方法选择2018年6月—2019年6月该院收治的踝关节手术患者90例,以抽签法的方式将其分为参照组和实验组,各45例,参照组行腰麻,实验组行超声引导下肢神经阻滞,对比两组患者阻滞起效、镇痛持续、感觉恢复时长,感觉、运动评估及并发症的发生率。结果实验组的阻滞起效(11.52±1.67)min、镇痛持续(14.59±1.66)min、感觉恢复时长(457.28±117.03)min均比参照组患者(3.38±1.19)min、(4.63±1.25)min、(319.15±143.28)min长,组间差异有统计学意义(t=26.629、32.153、5.009,P<0.001);两组患者对于感觉与运动的反应差异无统计学意义(Z=2.046、 3.103,P>0.05);此外,实验组患者并发症发生率6.67%低于参照组26.67%,组间差异有统计学意义(χ^2=6.480, P<0.05)。结论在踝部手术中,应用超声引导下肢神经阻滞的效果优于腰麻治疗,更具有安全性,且手术后能长效缓解患者疼痛,降低并发症的发生率。

Objective To compare the effects of ultrasound-guided lower limb nerve block and spinal anesthesia in ankle surgery. Methods A total of 90 patients undergoing ankle surgery in the hospital from June 2018 to June 2019 were selected. They were divided into a reference group and an experimental group by lottery, with 45 cases in each group. Spinal anesthesia was performed in the reference group and spinal anesthesia in the experimental group.Ultrasound-guided lower limb nerve block was used to compare the probability of block onset, duration of analgesia,sensory recovery time, sensory and motor evaluation, and other complications in the two groups. Results the experimental group’s block onset(11.52 ±1.67)min, analgesia duration(14.59 ±1.66)min, and sensory recovery time(457.28±117.03)min were longer than the reference group’s(3.38 ±1.19)min,(4.63±1.25)min,(319.15±143.28)min, the difference between groups was statistically significant(t=26.629,32.153,5.009, P<0.001);the two groups of patients had no significant difference in sensory and motor responses(Z=2.046, 3.103, P>0.05);In addition, the complication rate of the experimental group was 6.67%, which was lower than 26.67% of the reference group, and the difference between the groups was statistically significant(χ^2=6.480, P<0.05). Conclusion In ankle surgery, the effect of ultrasound-guided lower limb nerve block is better than spinal anesthesia, and it is safer. After the operation, it can relieve the patient’s pain and reduce the probability of other adverse complications.