Department of Postanesthesia Care Unit (PACU), Zhuzhou Central Hospital, Zhuzhou, 412000 Hunan, China.
Comput Math Methods Med. 2022 Aug 22;2022:4428883. doi: 10.1155/2022/4428883. eCollection 2022.
This study was aimed at investigating the clinical effect of ultrasound-guided nerve block based on the concept of enhanced recovery after surgery (ERAS) for postoperative anesthesia in patients with tibial fractures. The noise-reduction processing was introduced in ultrasound images to adjust the ultrasound clarity of the patient. A total of 177 patients with tibial fractures in our hospital were retrospectively analyzed and divided into OG group (general anesthesia combined with nerve block, 78 cases), C1 group (simple general anesthesia, 27 cases), C2 group (ultrasound-guided nerve block combined with general anesthesia, 10 cases), and C3 group (62 cases of spinal-epidural anesthesia). The effect of anesthesia and postoperative recovery time of patients in each group were analyzed. The wake-up time of the OG group was significantly shorter than that of the other three groups ( < 0.05). The doses of propofol and remifentanil in the OG group were much lower than those in the other groups ( < 0.05). After the ultrasound image was processed with noise reduction, the image showed the lesion more clearly. The excellent and good rates of OG group, C1 group, C2 group, and C3 group were 89.86%, 62.73%, 75.37%, and 61.07%, respectively. The Ramsay sedation score and anesthesia satisfaction in the OG group were obviously higher than those in the other groups, but there was no significant difference ( > 0.05). The visual analogue scale (VAS) scores of the OG group at 12 h, 24 h, and 36 h after the surgery were 4.52 ± 0.41, 4.72 ± 0.24, and 4.81 ± 0.74, respectively, which were significantly higher than those of the other three groups ( < 0.05). On the basis of ERAS, ultrasound-guided nerve block combined with general anesthesia can improve the perioperative pain in patients with tibial fractures and significantly shorten the time for the wake-up time. In addition, it was safe and reliable, so it was worthy of clinical promotion.
本研究旨在探讨基于加速康复外科（ERAS）理念的超声引导神经阻滞在胫骨骨折患者术后麻醉中的临床效果。对超声图像进行降噪处理，以调整患者的超声清晰度。回顾性分析我院收治的胫骨骨折患者 177 例，分为 OG 组（全麻复合神经阻滞，78 例）、C1 组（单纯全麻，27 例）、C2 组（超声引导神经阻滞复合全麻，10 例）和 C3 组（椎管内麻醉 62 例）。分析各组患者的麻醉效果和术后恢复时间。OG 组患者苏醒时间明显短于其他三组（<0.05）。OG 组丙泊酚和瑞芬太尼的用量明显低于其他三组（<0.05）。对超声图像进行降噪处理后，图像显示病变更清晰。OG 组、C1 组、C2 组和 C3 组的优良率分别为 89.86%、62.73%、75.37%和 61.07%。OG 组的 Ramsay 镇静评分和麻醉满意度明显高于其他组，但差异无统计学意义（>0.05）。OG 组术后 12、24、36 h 的视觉模拟评分（VAS）分别为 4.52±0.41、4.72±0.24、4.81±0.74，明显高于其他三组（<0.05）。在 ERAS 的基础上，超声引导神经阻滞复合全麻可改善胫骨骨折患者围术期疼痛，明显缩短苏醒时间。此外，该方法安全可靠，值得临床推广。
