Efficacy of tibial nerve block achieved through different approaches combined with patient-controlled intravenous analgesia for surgical treatment of calcaneus fractures / 中国基层医药

ABSTRACT

Objective:To investigate the efficacy of tibial nerve block achieved through different approaches combined with patient-controlled intravenous analgesia for surgical treatment of calcaneus fractures.Methods:This is a case-control study. A total of 80 patients scheduled for calcaneus surgeries at Guangxi Orthopedic Hospital from January to December 2022 were randomly assigned to undergo either a tibial nerve combined with medial sural nerve block on the upper leg (T1 group, n = 40) or a tibial nerve block on the popliteal fossa (T2 group, n = 40). All nerve blocks were performed under ultrasound guidance. Following surgery, the same medication was used to set up the intravenous infusion pump. At 6, 12, 24, and 48 hours post-surgery, the Visual Analogue Scale scores were recorded. At 1 and 2 days post-surgery, the Pittsburgh Sleep Quality Index scores and the duration of postoperative sensory and motor nerve blocks were documented. The need for postoperative pain relief medication and the occurrence of nausea and vomiting were also recorded. Patient satisfaction with postoperative analgesia was assessed. Results:There was no significant difference in Visual Analogue Scale scores between the two groups at different time points after surgery (all P > 0.05), and there was no significant difference in Pittsburgh Sleep Quality Index scores between the two groups after surgery ( P > 0.05). The duration of postoperative sensory and motor nerve block in the T1 group were (20.98 ± 2.06) hours and (18.88 ± 2.31) hours, respectively, which were significantly shorter than (22.75 ± 1.71) hours and (20.78 ± 1.95) hours in the T2 group ( t = -4.20, -3.97, both P < 0.001). There was no significant difference in patient satisfaction with postoperative analgesia between the two groups ( P > 0.05). Conclusion:Two different approaches of tibial nerve block combined with an intravenous analgesia pump can provide satisfactory analgesic effects after surgical treatment of calcaneus fractures. Ultrasound-guided tibial nerve block combined with medial sural nerve block can more quickly restore postoperative limb motor function than tibial nerve block on the popliteal fossa.