Efficacy of ultrasound combined with nerve stimulator-guided suprapatellar anterior approach to sciatic nerve block in elderly patients undergoing knee arthroscopic surgery
10.3760/cma.j.cn131073.20191020.00527
- VernacularTitle:超声联合神经刺激仪引导髌骨上前路坐骨神经阻滞用于膝关节镜手术老年患者的效果
- Author:
Yongtao HE
1
;
Fei XING
;
Wei ZHANG
Author Information
1. 郑州大学第一附属医院麻醉与围术期医学部 450052
- From:
Chinese Journal of Anesthesiology
2020;40(5):622-624
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of ultrasound combined with a nerve stimulator-guided suprapatellar anterior approach to sciatic nerve block in elderly patients undergoing knee arthroscopic surgery.Methods:Seventy American Society of Anesthesiology physical status Ⅱ or Ⅲ patients, aged>65 yr, scheduled for elective knee arthroscopic surgery, were divided into 2 groups ( n=35 each) using a random number table method: suprapatellar anterior approach group (S group) and traditional anterior approach group (T group). Puncture was performed under the guidance of ultrasound and a nerve stimulator in both groups.When dorsiflexion or plantar flexion was induced by stimulation of 0.3 mA current intensity, 0.25% ropivacaine plus 1% lidocaine (0.4 ml/kg) was injected.The success of puncture and block, depth of puncture, time to complete block, duration of block, insufficient analgesia, responses to tourniquet-induced discomfort, and block-related complications were recorded.The patients were followed up for 48 h after operation for the recovery time of foot dorsiflexion on the affected side. Results:Compared with T group, the success rate of puncture and block were significantly increased, the time to complete nerve block was shortened, the incidence of intraoperative insufficient analgesia was reduced ( P<0.05 or 0.01), and no significant change was found in the depth of puncture, duration of block, and recovery time of foot dorsiflexion on the affected side in S group ( P>0.05). No nerve block-related complications were found in the two groups. Conclusion:Ultrasound combined with a nerve stimulator-guided suprapatellar anterior approach to sciatic nerve block can provide satisfactory analgesia for elderly patients undergoing knee arthroscopic surgery with a higher safety.
