【摘要】 目的评价连续胫神经阻滞与连续坐骨神经阻滞在跟骨手术术后镇痛应用的临床效果。方法采用前瞻性随机、对照研究。将择期行跟骨手术、美国麻醉医师协会(ASA)麻醉风险分级Ⅰ~Ⅱ级的患者,随机分为2组,分别采用超声引导技术,行腘窝后入路连续坐骨神经阻滞(A组)、胫神经阻滞(B组)。定位成功后置入连续刺激导管,0.2%罗哌卡因背景量为5 ml/h。置管后12、24、48 h记录患者视觉模拟评分(VAS)和肢体感觉阻滞、运动阻滞、辅助用药和患者满意度。结果本研究共纳入60例患者,每组30例。静息和运动12、24和48 h时点2组患者VAS评分的比较,差异均无统计学意义(P>0.05)。2组患者48 h内胫神经感觉完全阻滞率均为90.0%,A组胫神经运动完全阻滞率为50.0%,B组为53.3%,差异无统计学意义(P>0.05)。A组患者48 h内腓总神经感觉完全阻滞率为100.0%,B组为46.7%,A组腓总神经运动完全阻滞率为90.0%,B组为13.3%,2组比较差异均有统计学意义,A组高于B组(P<0.05)。2组患者48 h辅助用药和满意度评分比较,差异无统计学意义(P>0.05)。结论连续胫神经阻滞可以为跟骨手术提供良好的镇痛,同时可以降低腓总神经阻滞的发生率。更多还原

【Abstract】 Objective To compare the clinical results of continuous tibial nerve block and continuous sciatic nerve block in postoperative analgesia of calcaneus surgeries.Methods This study was a prospective,randomized,controlled study.ASAⅠ-Ⅱ patients undergoing calcaneus surgeries were randomly divided into two groups.The two groups were received ultrasound-guided continuous popliteal sciatic nerve block(group A) and tibial nerve block(group B) respectively.Continuous stimulation catheter was implanted after successful positioning,the background concentration of 0.2% ropivacaine was 5 ml/h.The VAS score,limb sensory block,limb motor block,adjuvant and patient satisfaction were recorded at12,24 and 48 h after catheter implantation.Results Comparing the VAS score of the two groups in 12,24 and 48 h,the differences were not statistically significant(P > 0.05).The two groups of patients with complete sensory block rate of the tibial nerve in 48 h were both 90.0%,and the complete motor block rate of tibial nerve in 48 h was 50.0% in group A and53.3% in group B,the difference was not statistically significant.The sensory block and motor block of the common peroneal nerve of the two groups in 48 h were compared.The completely sensory block rate in 48 h was 100.0% in group A and 46.7% in group B.The completely motor block rate in 48 h was 90.0% in group A and 13.3% in group B,the difference was statistically significant,group A was better than group B(P < 0.05).Adjuvant and patient satisfaction scores were compared,too,the differences were not statistically significant(P>0.05).Conclusion Continuous tibial nerve block can provide good analgesia for calcaneus surgeries while reducing the incidence of the peroneal nerve block.更多还原