| Objective:To observe the effect of dexamethomine(Dex)complex ropivacaine combined with saphenous nerve block(SNB)and popliteal sciatic nerve block(PSNB)on the ankle and/or malleolus with the comparison of the nature and extent of intraoperative and postoperative pain in operative patients.Methods:Selected 60 patients in our hospital who preparaed doing the ankle and/ or malleolus surgery,(ASA)grade: ? ~ ? grade,the patients were randomly divided into groupropivacaine(group R)and ropivacaine mixed group DEX(group DR),It is 30 patients in each group.In the preoperative ultrasound guided by the ipsilateral popliteal fossa saphenous nerve block(SNB)and popliteal sciatic nerve block(PSNB),into the local anesthetic mixture for the group D was 0.5% ropivacaine 15 m L + sterile saline15 m L,A total of 30 m L.Group DR of 0.5% ropivacaine 15 m L + 60 ug Dex,total30 m L.The sensation and the onset time and duration of motor block were recorded in the two groups.The pain grading index(PRI),visual analogous scale(VAS),and visual analogous scale(VAS)were recorded at 1 hour,4 hours,8 hours and 24 hours after anesthesia,before and after incision,using the simplified Mc Gill Scale(MPQ))Score scores andpresent pain intensity(present pain intensity,PPI)rating scores.Record the patients who usedthe tramadol and the satisfaction of anesthesia and the postoperativecomplications,such as operation fails,strayed into blood vessels,puncture hematoma,local anesthetics poisoning,nerve damage,hypotension,bradycardia or anesthesia complications such as paresthesia.Results:1.Compared with the group R,the onset time of the group DR(11.20 ± 2.77min)was significantly less than that of the group R(13.07±2.69min)(P <0.01),There was no significant difference in the onset time of sensory block between the two groups(P> 0.05).2.The duration of sensory block group DR(589.13 ± 46.78min)was significantly higher than that of group R(551.63±51.55min)(P <0.01),The duration of exercise blockgroup DR(441.10±62.95min)was significantly higher than that of group R(387.97±62.20min)(P <0.01)3.Using the simplified Mc Gill Scale(MPQ).The PRI was significantly higher than that in the control group(P <0.05).The level of PRI was significantly higher than that of the control group(P <0.05)(P<0.05).There was no significant difference between the two groups(P>0.05).4.The VAS score of the patients in the group DR was significantly lower than that in the group R(P <0.05).The current pain intensity(PPI)score at 1 h and 8 h after the group DR In the group R(P <0.05),the difference was not statistically significant(P> 0.05).5.There were 10 patients used the tramadol in the group R,and 7patients used the tramadol in the group DR.There were 9 patients in the group R who were not satisfied with analgesia and 5 patients in the groupDR were not satisfied with analgesia.There was no statistically significant difference in analgesic efficacy between the two groups(P>0.05).Conclusion:1.Dex combined with ropivacaine for the popliteal fossa at the sciatic nerve combined with occlusal nerve block,the region is clear,block perfect,with effective onset time,the role of long duration of the advantages of long.2.Dex complex ropivacaine for the popliteal fossa at the sciatic nerve combined with the hidden nerve block,analgesic effect is obvious,significantly reduce the patient's sensory and emotional pain,effectively extend the postoperative pain,help postoperative rapid recovery,easy and efficient anesthesia,Worthy of clinical promotion. |
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