神经阻滞与全身麻醉在跟骨骨折内固定术后疼痛控制中的价值

目的:探讨神经阻滞与全身麻醉在跟骨骨折内固定术后疼痛控制中的价值.方法:2019年1月到2019年10月选择在本院诊治的开放性跟骨骨折患者480例,按照入院顺序,根据随机数字表法分为研究组与对照组,各240例.所有患者都给予跟骨骨折内固定治疗与全身麻醉,观察组术后给予连续坐骨神经自控镇痛,对照组术后给予静脉自控镇痛,记...

Values of Nerve Block and General Anesthesia in Pain Control after Internal Fixation of Calcaneal Fracture

ABSTRACT Objective: To explore the values of nerve block and general anesthesia in pain control after internal fixation of calcaneal fractures. Methods: From January 2019 to October 2019, 480 cases of patients with open calcaneal fractures were selected for diagnosis and treatment in our hospital and were divided into study group and control group of 240 patients in each groups accorded to the order of admission and the random number table method. All patients were treated with calcaneal fractures internal fixation and general anesthesia. The observation group were given continuous self-controlled analgesia of the sciatic nerve after operation, and the control group were given intravenous self-controlled analgesia. Results: There were no statistically significant difference in surgical time, drainage time, and drainage volume compared between the two groups (P>0.05). The incision drying time and incision healing time in the study group were significantly shorter than those in the control group (P<0.05). The pain VAS scores of the observation group at 4 h, 24 h and 48 h after operation were significantly lower than those of the control group (P<0.05). There was no statistically significant difference in the level of sensory block between the two groups at 0, 1, and 2 (x² = 0.00, 0.083, 0.083, P=1.0, 0.773, 0.773). There was no statistical comparison between the two groups (P>0.05). The incidence of complications such as incision dehiscence, infection, subcutaneous hematoma, and marginal necrosis was 4.2 % in the study group at 1 month after operation, which was significantly lower than 15.8 % in the control group (x²=18.148, P=0.000). There was statistical significance (P<0.001). Conclusion: The application of nerve block and general anesthesia after internal fixation of calcaneal fractures has better analgesic effect, it does not affect the block effect, can promote patient recovery, and reduce the incidence of postoperative complications.