Urfalioglu Aykut, Gokdemir Onur, Hanbeyoglu Onur, Bilal Bora, Oksuz Gozen, Toker Melike, Gungor Leyla
Department of Anesthesia and Reanimation, Kahramanmaras Sutcu Imam University Medical Faculty Kahramanmaras, Turkey.
Elazig Research and Training Hospital, Plastic and Reconstructive Surgery Clinic Elazig, Turkey.
Int J Clin Exp Med. 2015 Oct 15;8(10):19388-93. eCollection 2015.
Regional anesthesia methods in the lower extremity include central blocks where spinal and epidural anesthesia are performed as well as peripheral nerve blocks, which are performed by injecting anesthetics locally to nerves. The study aimed to provide a retrospective comparison of unilateral spinal block and ankle block methods in foot operations. Some 60 ASA I-III patients who underwent operation under regional anesthesia were retrospectively examined. Two groups, known as the Unilateral Spinal Block Group (Group S) (n=30) and the Ankle Block Group (Group A) (n=30), were designed. Average blood pressure (ABP), heart rate (HR), block formation time (BFT), time for being ready for operation (TBRFO), total operation duration (TOD), visual analogue scale (VAS), first analgesic need time (FANT) and any complications were all recorded. The BFTs were longer in Group A than Group S, while the FANTs were longer in Group A postoperatively. When these decreases in Group A and Group S were compared with the basal values before the block, all decreases in Group S following the block were considered statistically significant (P<0.05), while the decreases in Group A in the 5(th) and 15(th) minutes were not considered statistically significant. The VASs measured postoperatively at the 6(th), 12(th) and 24(th) hours of Group A were lower than those of Group S (P≤0.05). Despite the longer block formation, the ankle block is safer when compared to the spinal anesthesia, which involves risky hemodynamic changes in patients with associated diseases.
下肢区域麻醉方法包括实施脊髓麻醉和硬膜外麻醉的中枢阻滞以及外周神经阻滞，外周神经阻滞是通过将麻醉剂局部注射到神经来进行的。本研究旨在对足部手术中单侧脊髓阻滞和踝关节阻滞方法进行回顾性比较。对约60例在区域麻醉下接受手术的美国麻醉医师协会（ASA）I - III级患者进行了回顾性检查。设计了两组，分别称为单侧脊髓阻滞组（S组）（n = 30）和踝关节阻滞组（A组）（n = 30）。记录平均血压（ABP）、心率（HR）、阻滞形成时间（BFT）、准备手术时间（TBRFO）、总手术时长（TOD）、视觉模拟评分（VAS）、首次镇痛需求时间（FANT）以及任何并发症。A组的BFT比S组长，而术后A组的FANT更长。当将A组和S组的这些降低值与阻滞前的基础值进行比较时，S组阻滞后的所有降低值均被认为具有统计学意义（P < 0.05），而A组在第5分钟和第15分钟时的降低值不具有统计学意义。A组术后第6小时、12小时和24小时测量的VAS低于S组（P≤0.05）。尽管阻滞形成时间较长，但与脊髓麻醉相比，踝关节阻滞更安全，脊髓麻醉会给伴有相关疾病的患者带来危险的血流动力学变化。
