中国医学创新2024，Vol.21Issue(1)：5-9,5.DOI:10.3969/j.issn.1674-4985.2024.01.002
不同时间股神经-坐骨神经阻滞对胫腓骨骨折患者术后疼痛与谵妄的影响比较
Comparison of the Effects of Femoral-sciatic Nerve Block at Different Times on Postoperative Pain and Delirium in Patients with Tibiofibular Fractures
摘要
Abstract
Objective:To compare the effects of femoral-sciatic nerve block at different times on postoperative pain and delirium in patients with tibiofibular fractures.Method:A retrospective analysis was used to divide 100 patients with tibiofibular fractures admitted to Department of Anesthesiology,Fuzhou Second Hospital from July 2022 to June 2023 into group A and group B based on different times of femoral nerve sciatic nerve block.Group A had 50 patients who received femoral-sciatic nerve block after tracheal intubation and before surgical skin incision(before surgery),while group B had 50 patients who received femoral nerve sciatic nerve block immediately after surgical suture(after surgery),the other anesthesia methods in both groups were the same.The anesthesia effect,postoperative pain level,cognitive function,postoperative delirium,and incidence of adverse reactions in both groups were observed.Result:The duration of nerve block analgesia in group A was longer than that in group B,with significant difference(P＜0.05),and the postoperative recovery time in group A was earlier than that in group B,Propofol dosage and Remifentanil dosage in group A were lower than those in group B,with significant differences(P＜0.05).The visual analogue scale(VAS)scores at 2,6,12,24 h after surgery in group A were lower than those in group B,with significant differences(P＜0.05).The mini-mental state examination(MMSE)scores of two groups were lower at 1 and 3 d after surgery than before surgery,the MMSE scores of group A were higher than those of group B at 1 and 3 d after surgery,with significant differences(P＜0.05).The incidence of postoperative delirium in group A was lower than that in group B,with significant difference(P＜0.05).The incidence of adverse reactions in group A was lower than that in group B,with significant difference(P＜0.05).Conclusion:The application effect of preoperative femoral-sciatic nerve block in the surgery of patients with tibiofibular fractures is good,compared with postoperative femoral-sciatic nerve block,it can prolong the duration of nerve block analgesia,shorten postoperative recovery time,reduce the amount of anesthesia maintenance medication,alleviate postoperative pain and cognitive function damage,reduce the incidence of postoperative delirium and adverse reactions.关键词
股神经-坐骨神经阻滞/胫腓骨骨折/术后疼痛/谵妄Key words
Femoral-sciatic nerve block/Tibiofibular fractures/Postoperative pain/Delirium引用本文复制引用
刘景铠,谢东进,陈晓梅..不同时间股神经-坐骨神经阻滞对胫腓骨骨折患者术后疼痛与谵妄的影响比较[J].中国医学创新,2024,21(1):5-9,5.基金项目
福州市临床重点专科建设项目(20220202) （20220202）
