摘要
目的观察超声引导下连续坐骨神经阻滞应用于跟骨骨折术后镇痛的效果。方法择期行跟骨骨折切开复位内固定手术患者60例，随机分为超声引导下连续坐骨神经阻滞组（PCNA组）和静脉镇痛组（PCIA组），每组各30例。所有患者均采用蛛网膜下腔麻醉完成手术，PCNA组患者术毕在超声引导下坐骨神经置管，行连续坐骨神经阻滞镇痛；PCIA组患者术毕行自控静脉镇痛。观察并记录术后VAS评分、患肢改良Bromage评分、PCA按压次数和使用帕瑞昔布钠辅助镇痛的总量，以及不良反应，并评价患者对术后镇痛的满意度。结果PCNA组患者在术后8、12、24h时VAS评分低于PCIA组（P〈O．05），在各时段内PCA按压次数和使用帕瑞昔布钠的总量均少于PCIA组（P〈O．05），不良反应发生率（3．3％）低于PCIA组（56．7％）（P〈O．05），患者满意度（96．7％）高于PCIA组（70．0％）（P〈O．05）。结论超声引导下连续坐骨神经阻滞应用于跟骨骨折术后镇痛效果满意，且不良反应发生率较低，患者满意度高。
Objective To observe the postoperative analgesia efficacy of ultrasound-guided continuous sciatic nerve block for patients after calcaneal surgery. Methods Sixty patients scheduled for calcaneal surgery were randomly divided into ultrasound-guided continuous sciatic nerve block group （group PCNA） and intravenous analgesia group （group PCIA）, 30 patients in each group. The operations were undergone with subarachnoid anesthesia. Catheters were placed around the sci- atic nerve under ultrasonic guidance and continuous sciatic nerve block were used for postoperative analgesia in group PCNA, and patients in group PCIA were treated with continuous intravenous anal- gesia. Visual analogue scale （VAS）, modified Bromage score of broken limb, the PCA press number and the auxiliary dosage of parecoxib sodium after the operation, and the incidence of adverse reac- tions were observed and recorded. The rates of patient satisfaction with postoperative analgesia were evaluated. Results VAS was significantly lower in group PCNA than that in group PCIA at 8, 12, 24 h after the operation （P^0. 05）, and the PCA press number and the auxiliary dosage of parecoxib sodium were significantly lower than those in group PCIA during 0-12 h, 12-24 h, 24-48 h after the operation （P〈0.05）. The incidence of adverse reactions in group PCNA （3.3%） was significantly lower than that in group PCIA （56.7%） （P〈0.05）, and the rate of patient satisfaction（96.7%） was significantly higher than that in group PCIA （70.0%） （P〈0.05）. Conclusion Ultrasound- guided continuous sciatic nerve block can provide satisfactory postoperative analgesia for calcaneal surgery, with lower incidence of adverse reactions, higher rate of patient satisfaction.
出处
《实用疼痛学杂志》
2014年第2期92-96,共5页
Pain Clinic Journal
关键词
超声检查
坐骨神经
神经传导阻滞
跟骨骨折
镇痛
Ultrasonograph
Sciatic nervet Nerve block
Calcaneus fractures
Analgesia
