Application Of Ultrasound-guided Fascia Iliaca And Anterior Sciatic Nerve Block In Lower Extremity Surgery Below The Knee Joint

Objective:To observe the effect of combined fascia iliaca compartment block and anterior approach to the sciatic nerve block in low extremity surgery as a conjunction of general anesthesia.Methods:From January 2017 to October 2019,100 patients who received lower limb surgery under knee joints were enrolled.All patients were randomly divided into two groups,the patients of the control group(n=50)were received general anesthesia.The patienets of the study group were received combined ultrasound-guided fascia iliaca compartment block and anterior approach to the sciatic nerve block followed with general anesthesia.The anesthesia effect,early postoperative recovery quality,complications and patient satisfaction of the two groups were compared.Results:The intraoperative phase dose of propofol,remifentanil and sufentanil in the study group was significantly less than that in the control group,and the early postoperative phase dose of sufentanil in the study group was lower than that in the control group(P<0.05).The MAP and HR in the study group were significantly lower than those in the control group from the beginning of surgery to the time when the patient left the recovery room(P<0.05).The dose of phenylephrine used in the study group was significantly less than that in the control group(P<0.05).There was no significant difference in the dose of atropine between the two groups(P>0.05).The duration of anesthesia in the study group was longer than that in the control group(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).The time of recovery and extubation in the study group was significantly less than that in the control group(P<0.05).The VAS scores of the patients in the study group when entering and leaving the PACU were less than those in the control group(P<0.05).The incidence of agitation in the study group was significantly less than that in the control group(P<0.05).The incidence of nausea and vomiting,chills,hypotension,hypertension and other complications in the study group was significantly lower than that in the control group(P<0.05).The score of anesthesia satisfaction in the study group was higher than that in the control group(P<0.05).Conclusion:The combined ultrasound-guided fascia iliaca compartment block and anterior approach to the sciatic nerve block followed with general anesthesia in patients undergoing lower extremity surgery below the knee joint showed better analgesic effect,shorten the time of recovery and extubation,reduce the incidence of complications,and improve patient satisfaction.