| Application of ultrasound-guided ropivacaine combined with dexamethasone nerve block in elderly patients with distal tibiofibular fracture |
| Received:October 26, 2022 Revised:December 09, 2022 Click here to download the full text |
| Citation of this paper:HUANG Yu-jie,CHEN Qian-zheng,HUANG Hong-hua.Application of ultrasound-guided ropivacaine combined with dexamethasone nerve block in elderly patients with distal tibiofibular fracture[J].Chinese Journal of Clinical Medicine,2023,30(1):116-120 |
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| Author Name | Affiliation | E-mail | | HUANG Yu-jie | Department of Anesthesiology, Nantong Haimen People's Hospital, Nantong 226100, Jiangsu, China | | | CHEN Qian-zheng | Department of Anesthesiology, Nantong Haimen People's Hospital, Nantong 226100, Jiangsu, China | | | HUANG Hong-hua | Department of Anesthesiology, Nantong Haimen People's Hospital, Nantong 226100, Jiangsu, China | h13912233908@163.com |
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| Abstract:Objective To explore the application effects of ultrasound-guided ropivacaine combined with dexamethasone femoral nerve and sciatic nerve block anesthesia in the operation of distal tibiofibular fracture in the elderly. Methods From January 2020 to July 2021, 60 elderly patients with unilateral distal tibiofibular fracture who underwent locking compression plate (LCP) internal fixation were selected in Nantong Haimen People’s Hospital and randomly divided into two groups, 30 patients in each group. All patients received ultrasound-guided femoral nerve combined with sciatic nerve block anesthesia. Group R was treated with 0.4% ropivacaine 40 mL, and group RD was treated with 0.4% ropivacaine 40 mL plus dexamethasone 10 mg. The anesthetic effect, the incidence of anesthesia related complications during and after operation, and the amount of analgesic pump solution used at 6 h, 12 h, 24 h and 48 h after operation were compared between the two groups. Results The rate of complete block in group R and RD was 90.0% and 93.3% respectively (P＞0.05). There was no significant difference between the two groups in VAS score before anesthesia and when the affected limb was moved at 30 min after anesthesia, and in the incidence of anesthesia related complications during and after surgery. The VAS score (4.8±0.6) of group R was significantly higher than that of group RD (2.8±0.5) when the affected limb was moved at 15 min after anesthesia (P＜0.001). The dosage of analgesic pump solution in group RD was significantly less than that in group R at 12 h, 24 h and 48 h after surgery (P＜0.001). There was no local anesthetic toxicity or respiratory depression occurred in both groups. One case of intraoperative nausea and one case of postoperative vomiting occurred in group R, and one case of postoperative nausea occurred in group RD. Conclusions Ultrasound-guided ropivacaine combined with dexamethasone nerve block can be effectively and safely used in the operation of distal tibiofibular fracture in the elderly, compared with ropivacaine alone. The onset effect of local anesthesia is faster, the amount of postoperative analgesic drugs can be reduced, and there is no significant increase in the incidence of complicaitons. |
| keywords:nerve block femoral nerve sciatic nerve dexamethasone distal tibiofibular fracture |
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