关键词: 超声引导, 腘窝上入路, 股骨大转子平面入路, 坐骨神经阻滞, 踝部骨折

Abstract: Objective During the anesthesia of ankle fractures,ultrasound-guided sciatic nerve block with different approaches is used to analyze the safety and effectiveness of anesthesia.Methods A retrospective analysis of 176 patients with ankle fractures admitted to our hospital from June 2020 to June 2021,patients in group P received sciatic nerve block(PA) in the superior popliteal approach(PA，92 cases),and patients in group G received The sciatic nerve block of the greater trochanteric plane approach(GTA)(84 cases).The operation time, onset time, sciatic nerve depth and pain score of nerve block were compared between the two groups.Results The operation time of nerve block[(3.16±0.68)min vs (6.07±0.94)min],onset time[(1.46±0.36)min vs (2.18±0.43)min] and sciatic nerve depth[(2.76±0.32)cm vs (3.45±0.58)cm] of patients between group P and group G were significant(P<0.05),the maintenance time of nerve blockin group P[(571.27±37.43)min vs (440.42±31.16)min] was significantly better than that in group G(P<0.05).The ankle pain score of patients in group P was significantly lower than that in group G(1.21±0.36 vs 2.26±0.46)(P<0.05);the proportion of muscle strength of grade Ⅲ and above patients in group P was significantly better than that in group G(97.83% vs 8.33%)(P<0.05).Conclusion The use of ultrasound-guided PA sciatic nerve block in patients with ankle fracture is satisfactory in relieving pain symptoms,maintaining muscle strength,and avoiding motor block.It can also effectively simplify surgical operations and avoid surgical trauma to rehabilitation influence.

Key words: ultrasound guidance, popliteal approach, greater trochanteric approach, sciatic nerve block, ankle fracture