Si Gao, Wang Liwei, Deng Minzhi, Sun Yihan, Cao Yuan, Fan Jixing, Zhu Tengjiao, Tian Yun, Lv Yang, Wu Changyi
Department of Orthopedics, Peking University Third Hospital, Beijing, China.
Department of Anesthesiology, Peking University Third Hospital, Beijing, China.
Front Med (Lausanne). 2025 Jul 21;12:1516874. doi: 10.3389/fmed.2025.1516874. eCollection 2025.
To compare the anesthetic and analgesic effects of popliteal sciatic nerve block and intrathecal anesthesia in acute Achilles tendon rupture patients undergoing surgery.
This retrospective cohort study analyzed 115 patients with acute Achilles tendon rupture who underwent surgery at Peking University Third Hospital between May and November 2023. After excluding cases lost to follow-up or declining participation, 96 patients were ultimately enrolled. Patients were divided into two groups based on the different anesthesia methods they received: the popliteal sciatic nerve block group (BG) and the spinal anesthesia group (SAG). The anesthesia effects intraoperatively were compared between the two groups using puncture satisfaction, immediate complications of puncture, anesthesia operation time, and puncture pain evaluation. Postoperative analgesic and anesthesia recovery effects were compared between the two groups using visual analog scale (VAS), analgesic satisfaction score, sleep score, and time to complete sensory recovery. Ankle joint mobility was used to compare postoperative motor recovery between the two groups.
Statistical analysis revealed that in terms of anesthesia effectiveness, the BG had a shorter anesthesia operation time (1.95 ± 0.40 min) than the SAG (7.44 ± 1.90 min), and the BG (5.4%) had fewer immediate puncture complications than the SAG (25.0%). Regarding analgesic effectiveness, the BG (4.10 ± 0.09) had higher analgesic satisfaction compared to the SAG (3.14 ± 0.11), and within 48 h postoperatively, wound VAS scores in the BG were consistently lower than those in the SAG. Postoperatively, the time for complete sensory recovery in the affected lower limb in the BG (9.29 ± 0.41 h) was significantly longer than that in the SAG (6.09 ± 0.42 h).
Compared to intrathecal anesthesia, the use of popliteal sciatic nerve block (PSNB) in Achilles tendon repair surgery resulted in shorter anesthesia operation time, fewer immediate puncture complications, higher patient satisfaction with analgesia, and longer duration of analgesic effect. PSNB may be preferred for reduced complications and prolonged analgesia.
比较腘窝坐骨神经阻滞与鞘内麻醉在急性跟腱断裂手术患者中的麻醉和镇痛效果。
这项回顾性队列研究分析了2023年5月至11月在北京大学第三医院接受手术的115例急性跟腱断裂患者。在排除失访或拒绝参与的病例后，最终纳入96例患者。根据患者接受的不同麻醉方法将其分为两组：腘窝坐骨神经阻滞组（BG）和脊髓麻醉组（SAG）。使用穿刺满意度、穿刺即刻并发症、麻醉操作时间和穿刺疼痛评估比较两组术中的麻醉效果。使用视觉模拟量表（VAS）、镇痛满意度评分、睡眠评分和完成感觉恢复的时间比较两组术后的镇痛和麻醉恢复效果。使用踝关节活动度比较两组术后的运动恢复情况。
统计分析显示，在麻醉效果方面，BG的麻醉操作时间（1.95±0.40分钟）比SAG（7.44±1.90分钟）短，且BG（5.4%）的穿刺即刻并发症比SAG（25.0%）少。在镇痛效果方面，BG（4.10±0.09）的镇痛满意度高于SAG（3.14±0.11），且术后48小时内，BG的伤口VAS评分始终低于SAG。术后，BG患侧下肢完全感觉恢复的时间（9.29±0.41小时）明显长于SAG（6.09±0.42小时）。
与鞘内麻醉相比，在跟腱修复手术中使用腘窝坐骨神经阻滞（PSNB）可缩短麻醉操作时间，减少穿刺即刻并发症，提高患者对镇痛的满意度，并延长镇痛效果持续时间。PSNB可能因并发症减少和镇痛时间延长而更受青睐。
