Application Of Continuous Sciatic Nerve Block In Postoperative Analgesia Of Calcaneus Fracture

Objective:to analyze and evaluate the value of continuous sciatic nerve block in the postoperative analgesia of calcaneal fracture.Methods:From March 2015 to April 2017,40 patients were selected for open reduction and internal fixation from the affiliated Hospital of Jining Medical College which with calcaneal fracture.Inclusion criteria:(1)According to the diagnostic criteria of calcaneal fracture.(2)ASA grade ?-?,age 21-75,body weight index(BMI)18-25 Kg / m2,male and female.(3)Voluntary participation in research and signature of informed consent.Exclusion criteria:(1)Patients who didn't want to participate in the study.(2)The age is >75,or the age of <21.(3)Patients with diabetic neuropathy,fibula muscle atrophy,etc.(4)Patients with puncture site infection,systemic infection and coagulation dysfunction were excluded.(5)Exclusion of pregnant and lactating women.The study group was randomly divided into two groups after operation group(Group of continuous sciatic nerve self-controlled analgesia,group PCNA)and control group(Group of intravenous self-controlled analgesia,group PCIA),20 Cases in each group were observed after operation 2.4.8.24.Pain and exercise pain scores at rest for 48 hours were recorded,and the cost of pain killer within 48 hours,and other analgesic drug use and adverse reactions were recorded.Results:The data of the study group are as follows(Group of continuous sciatic nerve self-controlled analgesia,group PCNA): The NRS of resting pain:2h 1.3±0.21:,4h1.4±0.46,8h 1.2±0.51,24 h 0.8±0.37,48 h 0.4±0.15,mean(1.1±0.21);Motion pain: 2h2.5±0.18,4h 2.3±0.52,8h 1.9±0.37,24 h 1.5±0.52,48 h 0.9±0.47,average(1.6±0.43),and no other analgesic drugs were used and there were no adverse reactions.Control group's data as follows(Group of intravenous self-controlled analgesia,group PCIA): The NRS of resting pain: 2h 4.5±0.64,4h 4.2±0.72,8h 1.2±0.51,24 h 4.4±0.29,48 h 3.7±0.31,mean(4.8±0.73).Motion pain: 2h 6.5±1.23,4h 6.1±1.57,8h 5.7±1.31,24 h 5.6±0.53,48h5.5±0.75,average(5.9±0.61)Points,need to use other analgesic drugs(morphine,flurbiprofen axetil),nausea and vomiting response.The cost of pain killer within 48 hours:the study group was lower than the control group.The difference of the two group's data is obviously and has statistical significance.(P <0.05).Conclusion:In the operation of calcaneal fracture,the pain was severe after operation,and the pain could be alleviated by routine patient-controlled intravenous analgesia,and the effect was poor.Continuous sciatic nerve block can relieve postoperative pain effectively.In particular,continuous sciatic nerve block guided by nerve stimulator and ultrasound can accurately place the tip of the catheter next to the sciatic nerve to ensure the block effect.Reducing the use of analgesic drugs and the incidence of related complications provide a new method for postoperative analgesia.The analgesic effect is accurate and can improve the compliance of patients with early functional exercise.It can reduce the incidence of complications such as deep vein thrombosis of lower extremity,falling pneumonia and so on.It is helpful for patients to recover quickly after operation,and to improve the satisfaction of patients.It is worth popularizing.