Tu Nguyen Huu, Hai Vu Minh, Diep Nguyen The, Luong Vu Dinh
Department of Anesthesia and Critical Care, Hanoi Medical University, Hanoi, Vietnam.
Department of Anesthesia and Critical Care, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam.
Mater Sociomed. 2024;36(3):217-221. doi: 10.5455/msm.2024.36.217-221.
Fractures of the long bones in the lower limbs are injuries that cause severe to extremely severe pain, posing risks to the patient's circulation, respiration, and even life. Pain management for patients with lower limb long bone fractures in the emergency department is critically important.
This study aimed to evaluate the feasibility of ultrasound-guided femoral and sciatic nerve blocks in patients with lower limb long bone fractures in the emergency department (ED). The secondary objective was to assess the effectiveness of this procedure as an adjunct to pain management in the ED.
This observational study included 133 ED patients with lower limb long bone fractures who received ultrasound-guided femoral and sciatic nerve blocks (anterior approach). Feasibility was assessed by observing and recording procedural duration, number of attempts, and technical complexity. The effectiveness of pain management was evaluated using the visual analog scale (VAS) at the 5th, 10th, 15th, 30th, 60th, and 120th minutes. Data were gathered and analyzed using SPSS 25.0. Quantitative variables were described using frequencies and percentages, while qualitative variables were presented as mean ± standard deviation. Paired-samples T-tests were used to compare the pain scores at different time points.
The mean age of participants was 54.21 ± 18.43 years (range 18-93), including 76 males and 57 females. The average procedural duration was 4.92 ± 1.51 minutes (range 2.4-8.5). All blocks were successful on the first attempt, with no complications. Post-procedure, pain scores decreased by 53.47% at the 5th minute, 72.73% at the 10th minute (p < 0.001), and 97.25% at 15 minutes (p < 0.001). Pain scores remained stable from 30 to 120 minutes (p < 0.001).
Ultrasound-guided femoral and sciatic nerve blocks (anterior approach) are feasible in the ED. This technique provides significant and sustained pain relief.
下肢长骨骨折是会导致严重至极重度疼痛的损伤，对患者的循环、呼吸乃至生命构成风险。急诊科对下肢长骨骨折患者的疼痛管理至关重要。
本研究旨在评估超声引导下股神经和坐骨神经阻滞在急诊科下肢长骨骨折患者中的可行性。次要目的是评估该操作作为急诊科疼痛管理辅助手段的有效性。
这项观察性研究纳入了133例接受超声引导下股神经和坐骨神经阻滞（前路）的急诊科下肢长骨骨折患者。通过观察和记录操作持续时间、尝试次数及技术复杂性来评估可行性。使用视觉模拟量表（VAS）在第5、10、15、30、60和120分钟评估疼痛管理的有效性。使用SPSS 25.0收集和分析数据。定量变量用频率和百分比描述，定性变量以均值±标准差表示。采用配对样本T检验比较不同时间点的疼痛评分。
参与者的平均年龄为54.21±18.43岁（范围18 - 93岁），其中男性76例，女性57例。平均操作持续时间为4.92±1.51分钟（范围2.4 - 8.5分钟）。所有阻滞首次尝试均成功，无并发症。操作后，第5分钟疼痛评分下降53.47%，第10分钟下降72.73%（p < 0.001），第15分钟下降97.25%（p < 0.001）。30至120分钟疼痛评分保持稳定（p < 0.001）。
超声引导下股神经和坐骨神经阻滞（前路）在急诊科是可行的。该技术能提供显著且持续的疼痛缓解。
