Subgluteal Approach Continuous Sciatic Nerve Block for Postoperative Analgesia in Calcaneal Fracture Patients_West China Medical Journal

Authors：

 SULi , LIUYing , XIANGRui , YANGGuang ,  ZHANGLan

Department of Anesthesiology, Orthopedic Hospital of Sichuan Province, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHANGLan, Email: zlzxm@163.com

Keywords：

Ropivacaine; Subgluteal approach; Continuous sciatic nerve block; Self-controlled intravenous analgesia; Calcaneal fracture surgery

DOI：

10.7507/1002-0179.20140081

Video：

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Objective To investigate the effect and safety of subgluteal approach continous sciatic nerve block with 0.2% ropivacaine for postoperative analgesia in calcaneal fracture patients. Methods Forty calcaneal fracture patients treated from May 2012 to January 2013 were randomly assigned to two groups:20 patients in continuous sciatic nerve block group (group CSB) and 20 patients in self-controlled intravenous analgesia group (group PCIA).Patients in group CSB were given subgluteal approach continuous sciatic nerve block,and PCA pump was connected to give 0.2% ropivacaine via continuous nerve block catheter continuously for analgesia.Patients in group PCIA were given PCA pump directly for self-controlled intravenous analgesia.The movement/rest VAS scores and Ramsay scores at 2,8,24,48 hours after surgery,the dose of other analgesia drugs after surgery,the satisfaction of patients and surgeons,and side effects were recorded. Results The movement and rest visual analogue scale (VSA) scores and the dose of analgesia drugs in group CSB were significantly lower than group PCIA at all time points (P<0.05).The satisfaction of patients and surgeons in group CSB was higher than group PCIA (P<0.05). Conclusion Compared with self-controlled intravenous analgesia,subgluteal approach continuous sciatic nerve block with 0.2% ropivacaine can provide better and safer postoperative analgesia for calcaneal fracture patients.

Citation： SULi, LIUYing, XIANGRui, YANGGuang, ZHANGLan. Subgluteal Approach Continuous Sciatic Nerve Block for Postoperative Analgesia in Calcaneal Fracture Patients. West China Medical Journal, 2014, 29(2): 262-265. doi: 10.7507/1002-0179.20140081 Copy

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4.	Vas L.Continuous sciatic block for leg and foot surgery in 160 children[J].Paediatr Anaesth,2005,15(11):971-978.
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7.	陳家麟.跟骨關節內骨折內固定手術臨床報告[J].實用骨科雜志,2011,17(5):412-416.
8.	王翀,田禾,屈建華,等.切開復位內固定術與保守治療比較治療移位的跟骨關節內骨折的系統評價[J].中國循證醫學雜志,2007,7(4):276-282.
9.	楊茂偉,初立偉,王旭東,等.跟骨關節內骨折手術治療與保守治療的系統評價[J].中國全科醫學,2009,12(7):554-557.
10.	Karmakar MK,Kwok WH,Ho AM,et al.Ultrasound-guided sciatic nerve block:description of a new approach at the subgluteal space[J].Br J Anaesth,2007,98(3):390-395.
11.	White PF,Issioui T,Skrivanek GD,et al.The use of a continuous popliteal sciatic nerve block after surgery involving the foot and ankle:does it improve the quality of recovery [J].Anesth Analg,2003,97(5):1303-1309.
12.	Vloka JD,Hadzi? A,April E,et al.The division of the sciatic nerve in the popliteal fossa:anatomical implications for popliteal nerve blockade[J].Anesth Analg,2001,92(1):215-217.
13.	Singelyn FJ,Aye F,Gouverneur JM.Continuous popliteal sciatic nerve block:an original technique to provide postoperative analgesia after foot surgery[J].Anesth Analg,1997,84(2):383-386.
14.	伊軍,許莉,林惠華.連續坐骨神經阻滯鎮痛時B超聯合刺激導管放置技術與羅哌卡因應用濃度[J].北京大學學報·醫學版,2010,42(5):535-538.

1. 劉玉芬.跟骨骨折患者術后疼痛的護理[J].護理實踐與研究,2010,7(5):72-73.
2. Taboada M,Alvarez J,Cortés J,et al.The effects of three different approaches on the onset time of sciatic nerve blocks with 0.75% ropivacaine[J].Anesth Analg,2004,98(1):242-247.
3. Casati A,Fanelli G,Borghi B,et al.Ropivacaine or 2% mepivacaine for lower limb peripheral nerve blocks[J].Anesthesiology,1999,90(4):1047-1052.
4. Vas L.Continuous sciatic block for leg and foot surgery in 160 children[J].Paediatr Anaesth,2005,15(11):971-978.
5. van Geffen GJ,Scheuer M,Müller A,et al.Ultrasound-guided bilateral continuous sciatic nerve blocks with stimulating catheters for postoperative pain relief after bilateral lower limb amputations[J].Anaesthesia,2006,61(12):1204-1207.
6. 鄭移兵,齊越峰.跟骨骨折治療研究進展[J].中國骨傷,2012,25(11):962-966.
7. 陳家麟.跟骨關節內骨折內固定手術臨床報告[J].實用骨科雜志,2011,17(5):412-416.
8. 王翀,田禾,屈建華,等.切開復位內固定術與保守治療比較治療移位的跟骨關節內骨折的系統評價[J].中國循證醫學雜志,2007,7(4):276-282.
9. 楊茂偉,初立偉,王旭東,等.跟骨關節內骨折手術治療與保守治療的系統評價[J].中國全科醫學,2009,12(7):554-557.
10. Karmakar MK,Kwok WH,Ho AM,et al.Ultrasound-guided sciatic nerve block:description of a new approach at the subgluteal space[J].Br J Anaesth,2007,98(3):390-395.
11. White PF,Issioui T,Skrivanek GD,et al.The use of a continuous popliteal sciatic nerve block after surgery involving the foot and ankle:does it improve the quality of recovery [J].Anesth Analg,2003,97(5):1303-1309.
12. Vloka JD,Hadzi? A,April E,et al.The division of the sciatic nerve in the popliteal fossa:anatomical implications for popliteal nerve blockade[J].Anesth Analg,2001,92(1):215-217.
13. Singelyn FJ,Aye F,Gouverneur JM.Continuous popliteal sciatic nerve block:an original technique to provide postoperative analgesia after foot surgery[J].Anesth Analg,1997,84(2):383-386.
14. 伊軍,許莉,林惠華.連續坐骨神經阻滯鎮痛時B超聯合刺激導管放置技術與羅哌卡因應用濃度[J].北京大學學報·醫學版,2010,42(5):535-538.

West China Medical Journal

Subgluteal Approach Continuous Sciatic Nerve Block for Postoperative Analgesia in Calcaneal Fracture Patients

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