Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2022; 10(13): 4064-4071
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4064
Clinical effect of ultrasound-guided nerve block and dexmedetomidine anesthesia on lower extremity operative fracture reduction
Cheng-Bin Ao, Ping-Lei Wu, Liang Shao, Jian-Ying Yu, Wei-Guo Wu
Cheng-Bin Ao, Ping-Lei Wu, Liang Shao, Jian-Ying Yu, Department of Anesthesiology, The People’s Hospital of Yuhuan, Taizhou 317600, Zhejiang Province, China
Wei-Guo Wu, Department of Orthopedics, Taizhou Luqiao Second People’s Hospital, Taizhou 318000, Zhejiang Province, China
Author contributions: Ao CB and Wu WG designed this retrospective study; Ao CB wrote the manuscript; Ao CB, Lei P, Shao L and Yu JY were responsible for sorting the data; and all authors contributed to the article and approved the submitted version.
Institutional review board statement: The study was approved by the Ethics Committee of Yuhuan City People's Hospital, Taizhou City, Zhejiang Province.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Guo Wu, BMed, Associate Chief Physician, Department of Orthopedics, Taizhou Luqiao Second People’s Hospital, No. 500 Industrial Road, Jinqing Town, Luqiao District, Taizhou 318000, Zhejiang Province, China. wu4628554@163.com
Received: December 27, 2021
Peer-review started: December 27, 2021
First decision: January 25, 2022
Revised: February 17, 2022
Accepted: March 15, 2022
Article in press: March 15, 2022
Published online: May 6, 2022
Abstract
BACKGROUND

Lower extremity fractures are mainly treated by surgical reduction, but this operation is often affected by the patient’s level of agitation and the type of anesthesia used. The main treatment for lower-extremity fractures is operative reduction. However, operations can often be affected by both agitation and the degree of anesthesia. Therefore, it is of great importance to develop an effective anesthesia program to effectively ensure the progress of surgery.

AIM

To discuss the effect of ultrasound-guided nerve block combined with dexmedetomidine anesthesia in lower extremity fracture surgery.

METHODS

A total of 120 hospital patients with lower extremity fractures were selected for this retrospective study and divided into an observation group (n = 60) and a control group (n = 60) according to the anesthesia scheme; the control group received ultrasound-guided nerve block; the observation group was treated with dextromethomidine on the basis of the control group, and the mean arterial pressure, heart rate (HR), and blood oxygen saturation were observed in the two groups.

RESULTS

The mean arterial pressure of T1, T2 and T3 in the observation group were 94.40 ± 7.10, 90.84 ± 7.21 and 91.03 ± 6.84 mmHg, significantly higher than that of the control group (P < 0.05). The observation group’s HR at T1 was 76.60 ± 7.52 times/min, significantly lower than that of the control group (P < 0.05); The observation group’s HR at T2 and T3 was 75.40 ± 8.03 times/min and 76.64 ± 7.11 times/min, significantly higher than that of the control group (P < 0.05). The observation group’s visual analog score at 2 h, 6 h and 12 h after operation was 3.55 ± 0.87, 2.84 ± 0.65 and 2.05 ± 0.40. the recovery time was 15.51 ± 4.21 min, significantly lower than that of the control group (P < 0.05). Six hours post-anesthesia, epinephrine and norepinephrine in the observation group were 81. 10 ± 21.19 pg/mL and 510. 20 ± 98.27 pg/mL, significantly lower than that of the control group (P < 0.05), and the mini-mental state exam score of the observation group was 25. 51 ± 1.15, significantly higher than that in the control group (P < 0.05).

CONCLUSION

Ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect in the operation of lower limb fractures and has little effect on the hemodynamics of patients.

Keywords: Ultrasound, Nerve block, Dexmedetomidine, Lower extremity fracture, Anesthesia effect

Core Tip: Ultrasound-guided nerve block is the main anesthetic method for surgical bone fracture reduction. This study found that the ultrasound-guided nerve block combined with dexmedetomidine has a good anesthetic effect during the operative reduction of lower limb fractures and has little effect on the hemodynamics of patients.