Abstract:Objective To compare the different effects of the three analgesic Methods in surgical patients with fracture of tibial plateau. Methods Ninety surgical patients with fracture of tibial plateau in Beijing Jishuitan Hospital were randomly divided into three groups: continuous femoral nerve block group (group F), continuous sciatic nerve block group (group S) and continuous intravenous analgesia group (group V). All anesthesia Methods were combined with spinal-epidural anesthesia. In group F and group S, the catheter for nerve block was respectively placed after operation and analgesic Methods in two groups, including analgesic total volume of 0.2% ropivacaine, basic doses of 5 ml/h, single adding dose of 5 ml and locking time of 30 minutes. In group V, 1 μg/ml sufentanil 250 ml, 3 ml/h, 3 ml and 15 minutes were corresponding Methods with group F and group S. For visual analogue scale (VAS) above 4, 50 mg pethidine acting as remedial analgesic drug was given. VAS scores in the three groups were compared at 4 h, 8 h, 12 h, 24 h, 36 h, 48 h after operation. The times of adding, total doses in 24 h and 48 h, the satisfaction with pain management, complications and coagulation function were recorded. Results The VAS scores in group F and group S were significantly lower than in group V, the difference was statistically significantly different (P<0.05). After 24 h, 48 h, dosages in Group F were (133.9±10.7) ml, (169.3±13.4) ml; (124.6±11.6) ml, (15.57±12.9) ml dosage in group S, respectively with the group V, the dosage of (172.1±15.2) ml, (233.4±14.1) ml were compared, the difference was statistically significant (P<0.05). The pressing times in Group F and Group S after operation 24 h and 48 h were compared with that in Group V, the difference was statistically significantly different (P<0.05). Conclusions Analgesic effect of the nerve block has an advantage over that of intravenous anesthesia. The effect of sciatic nerve block is better than that of femoral nerve block.
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