Effect of ultrasound-guided iliac fascia combined with sciatic nerve block on major cardiovascular adverse events in patients undergoing lower limb revascularization surgery
10.3969/j.issn.1006-5725.2024.11.011
- VernacularTitle:超声引导下髂筋膜联合坐骨神经阻滞对下肢血运重建患者术后主要心血管不良事件的影响
- Author:
Manman LIU
1
;
Wanxia XIONG
;
Meijing YING
;
Chao LIANG
;
Ming DING
Author Information
1. 复旦大学附属中山医院厦门医院麻醉科(福建厦门 361000)
- Keywords:
fascia iliaca;
sciatic nerve block;
major cardiovascular adverse events;
propensity score matching
- From:
The Journal of Practical Medicine
2024;40(11):1531-1536
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the impact of ultrasound-guided fascia iliaca compartment block on major cardiovascular events and postoperative prognosis in patients with lower limb aortoiliac occlusive disease(ASO).Methods This study was a retrospective study including 353 patients with lower limb arterial reconstruction surgery for ASO at Xiamen Hospital Affiliated to Zhongshan Hospital of Fudan University from January 2018 to January 2022.Patients were divided into two groups based on different anesthesia:the group receiving ultrasound-guided fascia iliaca block combined with sciatic nerve block(Group B)and the group receiving monitored anesthesia care(MAC)(Group M).The primary outcome was the occurrence of major adverse cardiovascular events after lower limb arterial reconstruction surgery in ASO patients.The secondary outcomes included the incidence of non-cardiac postoperative myocardial injury,postoperative amputation,and other adverse reactions such as postoperative delirium,nausea,and vomiting as well as postoperative laboratory indicators.By using propensity score matching to balance baseline characteristics before surgery,the impact of different anesthesia methods on the occurrence of MACE and prognosis after surgery in ASO patients was analyzed.Results After propensity score matching,the incidence of MACE in Group B was lower compared with Group M(10%vs.3.4%,P=0.038);The incidence of MINS in Group B(33%vs.25%,P=0.200);The amputation rate of Group B(4.2%vs.3.4%,P＞0.99);The incidence of complications in Group B was(6.8%vs.4.2%,P=0.39);There was no statistically significant differ-ence in postoperative laboratory indicators between the two groups(P＞0.05).Multivariate analysis showed that nerve block(OR=0.25,95%CI:0.05～0.93),postoperative HBG(OR=0.95,95%CI:0.91～0.99)were in-dependent factors in reducing the incidence of MACE.Conclusion Ultrasound-guidance fascia iliaca compartment block and sciatic nerve block could reduce the risk of major adverse cardiovascular events in patients undergoing lower limb arterial revascularization surgery.
