Clinical Observation of Ultrasound-Guided Nerve Block Anesthesia on Postoperative Pain Control of Fracture Patients

Abstract

To observe the postoperative pain control and clinical efficacy of ultrasound-guided nerve block anesthesia for patients with tibial fracture. A total of 128 patients with tibial fracture who received surgical treatment in our hospital from October 2020 to April 2021 were selected. The ultrasound guided anesthesia group and general anesthesia group were established by random number table method, with 64 patients in each group. Patients in the ultrasound-guided anesthesia group received ultrasound-guided nerve block anesthesia, and patients in the general anesthesia group received conventional general anesthesia. Observation times anesthetic effect in both groups, changes in hemodynamic parameters, digital pain scale (NRS) score as a result, compared two groups of patients with adverse reactions occur, change of the serum inflammatory factors indicators before and after operation, and USES the Pearson correlation coefficient analysis of the correlation between serum levels of inflammatory factor index and NRS score. The effect of anesthesia, postoperative recovery, directional force recovery, motor block and sensory block time of patients in ultrasound-guided anesthesia group decreased significantly than those in general anesthesia group (all $P<0.05$ ). The comparison of MAP, HR and RR at T1 and T2 levels between the two groups was statistically significant (all $P<0.05$ ). The changes of MAP, HR and RR in ultrasound guided anesthesia group were more stable than those in general anesthesia group.The NRS scores of patients in both groups showed an increasing trend with the extension of time. The 6 h, 12 h and 24 hNRS scores of patients in the ultrasound guided anesthesia group decreased significantly than those in the general anesthesia group (all $P<0.05$ ). The total incidence of adverse reactions in ultrasound guided anesthesia group decreased significantly than that in general anesthesia group ( $P<0.05$ ).The serum levels of inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in 2 groups increased significantly before surgery, and the levels of each index in ultrasound guided anesthesia group decreased significantly than that in general anesthesia group (ALL $P<0.05$ ). Pearson correlation coefficient showed that serum IL-6 and TNF-α levels were positively correlated with NRS score (all $P<0.05$ ). Ultrasound-guided nerve block anesthesia surgery can effectively improve the tibia fracture patients intraoperative anesthetic effect, improve patients with intraoperative and postoperative hemodynamic index of stability, the anesthesia surgery will exert positive effects on patients with postoperative pain control, can reduce the risk in patients with postoperative adverse reactions, reduce the postoperative patients with inflammatory factor activity. In addition, this paper found significant positive correlation between serum inflammatory factors IL-6 and TNF-α and NRF score, suggesting that serum IL-6 and TNF-α can be monitored for postoperative pain control in patients with tibial fracture, providing reference for improving postoperative treatment plan of patients.