ĐÁNH GIÁ HIỆU QUẢ VÔ CẢM TRONG PHẪU THUẬT CẲNG BÀN CHÂN CỦA PHƯƠNG PHÁP PHONG BẾ PHỐI HỢP THẦN KINH ĐÙI VÀ THẦN KINH HÔNG TO DƯỚI HƯỚNG DẪN SIÊU ÂM

Abstract

Objective: To compare the anesthetic efficacy of ultrasound-guided combined femoral and sciatic nerve block with spinal anesthesia in low leg and foot surgery. Subjects and Methods: A prospective, randomized controlled trial was conducted on 60 patients undergoing ankle and foot surgery from January 2025 to June 2025 at 108 Military Central Hospital. Results: The mean age in the spinal anesthesia (SA) group was 50.57 ± 14.38 years, whereas in the peripheral nerve block (PNB) group it was 62.83 ± 19.39 years. Most patients were ASA II, accounting for 83.3% in the SA group and 80% in the PNB group. The procedure time and sensory block onset were shorter in the SA group (3.6 ± 0.89 minutes and 4.97 ± 0.72 minutes, respectively) compared with the PNB group (6.8 ± 0.85 minutes and 17.4 ± 1.1 minutes, respectively). Respiratory parameters remained stable in both groups; however, the SA group showed a trend toward increased heart rate and decreased mean arterial pressure immediately after anesthesia, while no significant hemodynamic changes were observed in the PNB group. Adverse effects such as pruritus, shivering, urinary retention, and headache were noted in the SA group, but not in the PNB group. Conclusion: Ultrasound-guided combined femoral and sciatic nerve block provides effective anesthesia for ankle and foot surgery, with prolonged analgesia, stable respiratory and hemodynamic profiles, and fewer adverse effects compared with spinal anesthesia.