Clinical application of ultrasound-guided fascia iliaca compartment block and proximal popliteal sciatic nerve block on patients undergoing total knee arthroplasty
10.3760/cma.j.issn.1008-6706.2019.21.022
- VernacularTitle: 超声引导髂筋膜腔隙阻滞、近端腘窝坐骨神经阻滞在全膝关节置换术中的应用
- Author:
Xinli HUANG
1
;
Yanmei WANG
1
;
Wei LIU
1
;
Haitao SHI
2
;
Donghai LIU
1
Author Information
1. Department of Anesthesiology, the People′s Hospital of Langfang, Langfang, Hebei 065000, China
2. Department of Anesthesiology, the People′s Hospital of Yanqi County, Xinjiang 841100, China
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Anesthesia and analgesia;
Neuromuscular blockade;
Arthroplasty, replacement, knee;
Comparative study
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(21):2660-2663
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the application of ultrasound-guided fascia iliaca compartment block(FICB) and proximal popliteal sciatic nerve block(PPSNB) on patients undergoing total knee arthroplasty.
Methods:From January 2015 to January 2018, 60 patients scheduled for total knee arthroplasty undergoing laryngeal mask airway(LMA) general anesthesia in the People′s Hospital of Langfang were divided into three groups by the random number table, with 20 cases in each group.Before general anesthesia, every patient received dezocine 5mg iv, group A received FICB, group B received FICB combined with PPSNB(extraparaneural), group C received FICB combined with PPSNB(subparaneural).40mL of 0.375% ropivacaine was injected guiding by ultrasound.The dosage of propofol and remifentanil, time of awake, awake visual analogue scale(VAS), mean arterial blood pressure(MAP) and heart rate(HR) at pre-block(T1), LMA insert(T2), skin incision(T3), femoral bone cutting(T4), LMA remove(T5), and awake stage(T6) were recorded.The incidence of using vasoactive drugs and adverse reaction were also recorded.
Results:The dosage of propofol and remifentanil, the time of awake and awake VAS in group A, group B and group C were: group A (768.0±8.5)mg, (977±21)μg, (18.4±2.1)min, (4.2±0.7)points; group B (554.0±7.1)mg, (775±12)μg, (12.3±1.6)min, (2.4±0.6)points; group C (530±8.2)mg, (738±15)μg, (11.8±1.7)min, (1.3±0.5)points.The dosage of propofol and remifentanil, time of awake, awake VAS in group B and group C were significantly lower than those in group A (F=29.23, 42.56, 32.42, 19.31, all P<0.05). The awake VAS in group C was lower than that in group B (q=8.12, P<0.05). MAP and HR at T2, T3, T4, T5 and T6 in group B or group C were significantly lower than those in group A (MAP: F=85.66, 78.46, 86.04, 62.75, 61.31; HR: F=26.03, 42.75, 38.04, 29.31, 31.50, all P<0.05). The number of patients who required vasoactive drugs and adverse reaction in group B or group C were significantly lower than those in group A (χ2=11.32, 12.81, 15.24, 15.24, 10.15, all P<0.05). The incidence rates of incision pain at awake stage in group A, group B and group C were: group A(30%), group B(20%), group C(0%), that in group C was lower than group B (χ2=9.87, P<0.05).
Conclusion:The ultrasound-guided FICB and PPSNB(subparaneural) can obviously reduce the dosage of general anaesthetic and maintain the stability of hemodynamics in patients undergoing total knee arthroplasty.It has effective analgesia and less adverse reactions during sober.
