Đánh giá tác dụng giảm đau sau phẫu thuật của gây tê thần kinh hông to dưới hướng dẫn siêu âm

Abstract

Summary

Objective: To compare the postoperative analgesic effect of single shot ultrasound-guided popliteal sciatic block technique at pre-division position and immediately after division into the tibial nerve (TN) and the common peroneal nerve (CPN) in patients undergoing foot osteosynthesis. Subject and method: 70 patients aged from 18 to 80 years old, ASA I, II, were blocked ultrasound-guided popliteal sciatic with 20ml bupivacain 0.25% and adrenalin 1/200.000, categorized into 2 groups. Group 1: Injected at the anterior position divided into TN and CPN, group 2: Injected at the immediately posterior position divided into TN and CPN. Result: The mean onset time in group 2 (2.66 ± 1.3 minutes) was lower than group 1 (4.86 ± 1.91 minutes) with p<0.05. The analgesic duration of group 2 (21.69 ± 1.7 hours) was longer than that of group 1 (19.03 ± 2.8 hours) (p<0.05). The VAS at rest in group 2 were lower than group 1, p<0.05 at the time mark after block 03 minutes, 20 minutes, 3, 18, 24 hours, The VAS at movement in group 2 were lower than group 1, p<0.05 at the time mark after block 03 minutes, 20 minutes, 3, 12, 18, 24 hours. No complications were recorded during the technical implementation. Conclusion: Ultrasound-guided popliteal sciatic block at the immediately after division had shorter onset time, longer analgesic duration time, the analgesic effect during 24 hours after anesthesia better than the position pre- divided into the tibial nerve (TN) and the common peroneal nerve (CPN).

Keywords: Popliteal sciatic nerve block, ankle and foot surgery, common sciatic nerve (Vloka’s) seath.