Ojective To evaluate the efficacy of single gastrocnemius plane block for postoperative analgesia in patients undergoing elective foot and ankle surgery under general anesthesia.
Methods Sixty patients undergoing foot and ankle surgery were selected, including 34 males and 26 females, aged 18-64 years, BMI 18-28 kg/m2, ASA physical status Ⅰ-Ⅲ. Patients were randomly divided into two groups: GPB group and control group, 30 cases in each group. Preoperative GPB was performed in the GPB group, and a total of 0.375% ropivacaine 30 ml was injected into the gastrocnemius surface, without GPB in the control group. The methods of induction and maintenance of anesthesia were the same in the two groups. All patients were given oxycodone analgesia pump without background dose after operation. The NRS score at rest and during activity (dorsal curvature and metatarsal curvature of foot and ankle) at 4, 8, 12, 16, 24, 48 hours after operation, the area under the pain-time curve at 0-16, 16-24, 24-48, 0-48 hours after operation (AUC)were recorded. The intraoperative dosage of remifentanil, the rescue of inland dezocine 48 hours after operation, and oxycodone drops 0, 4, 8, 12, 16, 24, 48 hours after operation were recorded. The effective pressing times, the total pressing times and the first pressing time were recorded 48 hours after operation, and the postoperative hospital stay and the first time to get out of bed were recorded. The adverse reactions such as dizziness, fever, nausea and vomiting, skin pruritus and neurological complications were recorded.
Results Compared with the control group, 0-16, 0-48 hours AUC at rest, 0-16, 0-48 hours AUC during activity, dizoxin rescue times, oxycodone titration 0, 4, 8, 12, 16, 24, 48 hours after operation, effective pressing times and total pressing times decreased significantly in the GPB group 4, 8, 12, 16, 24, 48 hours after operation, the first pressing time was significantly prolonged (P < 0.01). There was no significant difference in NRS score at rest and activity between the two groups 24 and 48 hours after operation. There was no significant difference in the time of getting out of bed for the first time, the incidence of dizziness, fever, nausea and vomiting, and skin pruritus between the two groups.
Conclusion Ultrasound-guided gastrocnemius plane block is a new approach for precise block of tibial nerve, common peroneal nerve, medial sural cutaneous nerve and lateral sural cutaneous nerve. This method can provide effective postoperative analgesia for patients undergoing foot and ankle surgery. |
