Department of Radiology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
Department of Radiology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
J Vasc Interv Radiol. 2022 Mar;33(3):279-285. doi: 10.1016/j.jvir.2021.10.018. Epub 2021 Oct 28.
To evaluate the ability of subgluteal sciatic nerve block (SSNB) to provide pain control during endovascular treatment of below-the-knee (BTK) occlusions.
This randomized prospective controlled study evaluated 60 consecutive adult patients who underwent endovascular treatment for BTK occlusions. The patients were randomized into 2 equal groups; the SSNB group underwent SSNB in the subgluteal space under ultrasound guidance, while the control group received fentanyl as an analgesic. The visual analog scale (VAS) and Face, Legs, Activity, Cry, Consolability (FLACC) scale scores were recorded.
Compared with the control group, the SSNB group showed significantly lower median VAS (0 [range, 0-30] vs 70 [range, 20-100], P < .001) and median FLACC scale (0 [range, 0-2] vs 6 [range, 3-10], P < .001) scores. There was no statistically significant difference between the 2 groups regarding the remaining parameters. There was a very strong correlation between the VAS and FLACC scale scores in both the SSNB (r = 0.805, P < .001) and control (r = 0.950, P < .001) groups. The procedure time and total balloon inflation time correlated with the VAS (r = 0.411, P = .024, and r = 0.402, P = .031, respectively) and FLACC scale (r = 0.431, P = .017, and r = 0.414, P = .022, respectively) scores in the control group but not in the SSNB group (r = 0.364, P = .056, and r = 0.300, P =.085, respectively, for correlation with VAS score and r = 0.730, P = .068, and r = 0.704, P = .075, respectively, for correlation with the FLACC scale score).
SSNB is a highly effective and safe pain management modality for the endovascular treatment of BTK occlusions.
评估臀下坐骨神经阻滞（SSNB）在膝下（BTK）闭塞的血管内治疗中提供疼痛控制的能力。
这项随机前瞻性对照研究评估了 60 例连续接受 BTK 闭塞血管内治疗的成年患者。患者随机分为两组；SSNB 组在超声引导下进行臀下坐骨神经阻滞，而对照组接受芬太尼作为镇痛剂。记录视觉模拟量表（VAS）和面部、腿部、活动、哭泣、安慰（FLACC）量表评分。
与对照组相比，SSNB 组的 VAS 中位数（0 [范围，0-30] 与 70 [范围，20-100]，P <.001）和 FLACC 量表中位数（0 [范围，0-2] 与 6 [范围，3-10]，P <.001）显著降低。两组在其余参数方面无统计学差异。在 SSNB 组（r = 0.805，P <.001）和对照组（r = 0.950，P <.001）中，VAS 和 FLACC 量表评分之间均存在很强的相关性。手术时间和总球囊充气时间与 VAS（r = 0.411，P =.024 和 r = 0.402，P =.031）和 FLACC 量表（r = 0.431，P =.017 和 r = 0.414，P =.022）评分相关，在对照组中，但在 SSNB 组中则没有（r = 0.364，P =.056 和 r = 0.300，P =.085，分别为与 VAS 评分相关，r = 0.730，P =.068 和 r = 0.704，P =.075，分别为与 FLACC 量表评分相关）。
SSNB 是膝下 BTK 闭塞血管内治疗中一种非常有效和安全的疼痛管理方式。
