Application of peripheral nerve block in anesthesia management of patients with trauma of the tibia and fibula / 第二军医大学学报

ABSTRACT

Objective To explore the value of peripheral nerve block for anesthesia management in patients with lower extremity injuries, so as to discuss its role in future war injury. Methods Totally 58 patients with open fracture of the lower limbs were anesthetized for external fixation and debridement, with the procedure simulating the anesthesia of war extremity injury management. After antishock treatment, the patients were randomly divided into Group P and Group S, with 29 in each group. Patients in Group P were anesthetized using fascia iliaca block combined with sciatic nerve block under ultrasound guidance, and spinal-epidural anesthesia was used in Group S. The general condition of patients, anesthesia complications, anesthesia efficiency, analgesia duration after anesthesia and patients overall satisfaction (VAS score) were compared between the two groups. Results There was no significant difference between the two groups in the general condition before anesthesia. After anesthesia, 20 patients (71%) in Group S suffered circulatory collapse and 2 patients (7%) in Group S suffered respiratory depression, and their conditions were stable (only with 1 patient dropped off due to intubation after anesthesiologist treatment). While no anesthesia complication occurred in Group P. Patients in Group P had a significantly shorter pre-operative anesthesia time than that in Group S (P<0. 01), and intra-operative infusion volume in Group P was lower than that in Group S (P<0. 01). The post-operative analgesia time in Group P was significantly longer than that in Group S (P<0. 01). The overall satisfaction and analgesia effect of patients in Group P was better than those in Group S (P<0. 01). Conclusion Peripheral nerve block anesthesia technique is safer and more comfortable than traditional spinal-epidural anesthesia for patients with trauma of the tibia and fibula.