Effect of Ultrasound Image-Guided Nerve Block on the Postoperative Recovery Quality of Patients with Tibial Fractures Using the Concept of Enhanced Recovery after Surgery

This study was aimed at investigating the clinical effect of ultrasound-guided nerve block based on the concept of enhanced recovery after surgery (ERAS) for postoperative anesthesia in patients with tibial fractures. The noise-reduction processing was introduced in ultrasound images to adjust the ultrasound clarity of the patient. A total of 177 patients with tibial fractures in our hospital were retrospectively analyzed and divided into OG group (general anesthesia combined with nerve block, 78 cases), C1 group (simple general anesthesia, 27 cases), C2 group (ultrasound-guided nerve block combined with general anesthesia, 10 cases), and C3 group (62 cases of spinal-epidural anesthesia). The effect of anesthesia and postoperative recovery time of patients in each group were analyzed. The wake-up time of the OG group was significantly shorter than that of the other three groups ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> <a:mo><</a:mo> <a:mn>0.05</a:mn> </a:math> ). The doses of propofol and remifentanil in the OG group were much lower than those in the other groups ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>P</c:mi> <c:mo><</c:mo> <c:mn>0.05</c:mn> </c:math> ). After the ultrasound image was processed with noise reduction, the image showed the lesion more clearly. The excellent and good rates of OG group, C1 group, C2 group, and C3 group were 89.86%, 62.73%, 75.37%, and 61.07%, respectively. The Ramsay sedation score and anesthesia satisfaction in the OG group were obviously higher than those in the other groups, but there was no significant difference ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo>></e:mo> <e:mn>0.05</e:mn> </e:math> ). The visual analogue scale (VAS) scores of the OG group at 12 h, 24 h, and 36 h after the surgery were <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mn>4.52</g:mn> <g:mo>±</g:mo> <g:mn>0.41</g:mn> </g:math> , <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mn>4.72</i:mn> <i:mo>±</i:mo> <i:mn>0.24</i:mn> </i:math> , and <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mn>4.81</k:mn> <k:mo>±</k:mo> <k:mn>0.74</k:mn> </k:math> , respectively, which were significantly higher than those of the other three groups ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>P</m:mi> <m:mo><</m:mo> <m:mn>0.05</m:mn> </m:math> ). On the basis of ERAS, ultrasound-guided nerve block combined with general anesthesia can improve the perioperative pain in patients with tibial fractures and significantly shorten the time for the wake-up time. In addition, it was safe and reliable, so it was worthy of clinical promotion.