Application of Ultrasound-Guided Sciatic Nerve Block Combined with Combined Spinal-Epidural Anesthesia in Surgery for Femoral Neck Fractures

YANG Bo; GUO Kangning; MU Zhiming; ZHANG Xue; TIAN Weiwei

doi:10.13919/j.issn.2095-6274.ZHJY202505047

Abstract：Objective To investigate the effects of ultrasound-guided sciatic nerve block combined with combined spinal-epidural anesthesia(CSEA)on intraoperative hemodynamics,postoperative recovery quality,and pain in patients un-dergoing surgery for femoral neck fractures.Methods A retrospective analysis was conducted on the clinical data of 80 patients who underwent surgery for femoral neck fractures between June 2021 and May 2025.Based on the anesthesia pro-tocol,patients were divided into a control group(39 cases,receiving CSEA alone)and a study group(41 cases,receiving ultrasound-guided sciatic nerve block combined with CSEA).Intraoperative hemodynamic parameters,total ropivacaine dosage,postoperative recovery quality,pain scores,and adverse reactions were compared between the two groups.Re-sults There was no statistically significant difference in the total dosage of ropivacaine between the two groups(P>0.05).Compared with the control group,the study group demonstrated superior heart rate and mean arterial pressure at 30 min-utes and 1 hour after anesthesia induction,as well as at the end of surgery,indicating more stable hemodynamics(P<0.05).The study group also exhibited a shorter postoperative awakening time and a lower incidence of emergence agitation(P<0.05).Furthermore,the Visual Analog Scale(VAS)scores at 6,12,and 24 hours postoperatively were significantly lower in the study group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In femoral neck fracture sur-gery,with an equivalent total dosage of ropivacaine,the use of ultrasound-guided sciatic nerve block combined with CSEA,compared to CSEA alone,can more effectively maintain intraoperative hemodynamic stability,improve postoperative re-covery quality,provide superior postoperative analgesia,without increasing the risk of adverse reactions.