The Effect of Presacral-Retro-Psoas Space Block-Selective Nerve Root Block on the Dosage of Anesthetics in General Anesthesia for Below-Knee Osteoporotic Fractures and Its Clinical Significance
GENG Wei, et al
The First Affiliated Hospital of Suzhou University, Jiangsu Suzhou 215000, China
Abstract：Objective: To investigate the effect of presacral-retro-psoas space block-selective nerve root block on the dosage of anesthetics during general anesthesia in patients with osteoporotic fractures below the knee and its clinical significance. Methods: From January 2020 to June 2021,70 patients with osteoporotic fractures below the knee who were treated in the Department of Orthopaedic Surgery of our hospital and received surgical treatment were selected as subjects,and divided into general anesthesia group according to different anesthesia methods (n=37,Simple general anesthesia) and combined group (n=33,presacral-retro-psoas space block-selective nerve root block assisted by general anesthesia).The fluctuations of hemodynamic indexes [heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),mean arterial pressure (MAP)] in the combined group before and after nerve block were observed; the pain at each time point after the operation was compared between the two groups Differences in visual analogue scale (VAS) score,perioperative anesthetic dosage,postoperative recovery and other indicators. Results: There were no significant differences in HR,SBP,DBP and MAP fluctuation at 5min,10min and 20min after nerve block in combined group compared with before the block (P>0.05).The dosage of remifentanil in the combined group was (0.77±0.03) mg,less than that in the general anesthesia group (0.90±0.05) mg (P<0.05),and the number of relief analgesia of sufentanil in the combined group was (0.84±0.14) times,less than that in the general anesthesia group (1.30±0.27) times (P<0.05).There were significant differences in VAS scores at all time points in the rest and exercise states in the combined group (P<0.05),there were significant differences in VAS scores at all time points in the rest state in the general anesthesia group (P<0.05),and there was no significant difference in VAS scores at all time points in the exercise state (P>0.05).VAS scores in the combined group at 6h,12h and 24h after surgery were lower than those in the general anesthesia group (P<0.05),and VAS scores in the combined group at 12h after surgery at exercise were lower than those in the general anesthesia group (P<0.05).There was no significant difference in the time of anal exhaust between the two groups (P>0.05),and the time of passive exercise in bed in the combined group was (3.36±0.32) h,which was earlier than that in the general anesthesia group (4.02±0.33) h (P<0.05). Conclusion: The presacral-retro-psoas major space block-selective nerve root block combined with general anesthesia has stable hemodynamics in patients with below-knee osteoporotic fracture surgery,which can effectively reduce the amount of perioperative anaesthetic drugs and improve the analgesic effect,which is of specific clinical significance in promoting the postoperative recovery of patients.
耿玮, 纪玉玮. 骶前-腰大肌后间隙阻滞-选择性神经根阻滞对全麻膝下骨质疏松性骨折全身麻醉中麻醉药物用量的影响及其临床意义[J]. 河北医学, 2022, 28(7): 1172-1177.
GENG Wei, et al. The Effect of Presacral-Retro-Psoas Space Block-Selective Nerve Root Block on the Dosage of Anesthetics in General Anesthesia for Below-Knee Osteoporotic Fractures and Its Clinical Significance. HeBei Med, 2022, 28(7): 1172-1177.
2022, Vol. 28 
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