中国合理用药探索2026，Vol.23Issue(5)：86-92,7.DOI:10.3969/j.issn.2096-3327.2026.05.012
0.33%罗哌卡因用于超声引导下腘窝坐骨神经阻滞在踝关节骨折手术中的应用
Application of 0.33%Ropivacaine in Ultrasound-Guided Popliteal Sciatic Nerve Block for Ankle Fracture Surgery
摘要
Abstract
Objective:To compare the anesthetic effect and postoperative recovery quality of 0.33%ropivacaine in ultrasound-guided popliteal sciatic nerve block for ankle fracture surgery.Methods:A retrospective analysis was performed on 180 patients undergoing open reduction and internal fixation or ligament repair for ankle fracture from April 2020 to December 2022.Patients were divided into control group(0.50%ropivacaine,n=98)and observation group(0.33%ropivacaine,n=82).All patients received ultrasound-guided popliteal sciatic nerve block with 20 ml corresponding concentration of ropivacaine hydrochloride injection,followed by spinal anesthesia after satisfactory block.Baseline data,postoperative motor and functional recovery indexes,intraoperative anesthetic and block effect,postoperative analgesia indexes and complications were compared.Kaplan-Meier method and Log-rank test were used to compare the time to first analgesic requirement.Multivariate Logistic regression was used to analyze the influencing factors of 6-hour postoperative motor function recovery.Results:There was no significant difference in baseline data between the two groups(P>0.05).At 6 hours after operation,the proportion of active foot movement in the observation group was higher,and the time to first ambulation was shorter than that in the control group(P<0.05).The onset time and completion time of motor block in the control group were shorter(P<0.05),while no significant difference was found in sensory block onset time(P>0.05).The postoperative block duration and time to first analgesic requirement in the observation group were shorter,while 24-hour opioid consumption was higher(P<0.05).Log-rank test showed a significant difference in median time to first analgesic requirement(12.8 h vs 11.2 h,χ2=6.365,P=0.012).No significant difference was observed in the total incidence of complications(P>0.05).Multivariate Logistic regression showed that 0.33%ropivacaine was an independent protective factor for 6-hour postoperative motor function recovery(OR=2.160,95%CI:1.112～4.195,P=0.023).Conclusion:In ultrasound-guided popliteal sciatic nerve block for ankle fracture surgery,0.33%ropivacaine has equivalent intraoperative anesthetic efficacy to 0.50%ropivacaine.It can shorten postoperative block duration,accelerate motor function recovery,and does not increase the incidence of complications.关键词
罗哌卡因/浓度/超声引导/神经阻滞/腘窝坐骨神经/踝关节骨折Key words
ropivacaine/concentration/ultrasound-guided/nerve block/popliteal sciatic nerve/ankle fracture分类
医药卫生引用本文复制引用
毕路甲,张秀珍,闫军杰,黄美洁,冯东亮..0.33%罗哌卡因用于超声引导下腘窝坐骨神经阻滞在踝关节骨折手术中的应用[J].中国合理用药探索,2026,23(5):86-92,7.基金项目
河南省医学科技攻关计划项目(LHGJ20221034) （LHGJ20221034）
