Application of Intelligent Ultrasound in Real-Time Monitoring of Postoperative Analgesic Nerve Block

[Comparison of the effects of sciatic nerve block combined with continuted femoral nerve block or continuted adductor canal block on pain and motor function after total knee arthroplasty]

Objective

To compare the effect of sciatic nerve block (SNB) combined with continuted femoral nerve block (FNB) or continuted adductor canal block (ACB) on pain and motor function after total knee arthroplasty (TKA).

Methods

A total of 60 patients with TKA-treated osteoarthritis of the knee who met the selection criteria were enrolled between November 2020 and February 2021 and randomised allocated into the study group (SNB combined with continuted ACB) and the control group (SNB combined with continuted FNB), with 30 cases in each group. There was no significant difference in gender, age, body mass, height, body mass index, preoperative Hospital for Special Surgery (HSS) score, femoral tibial angle, and medial proximal tibial angle between the two groups ( P>0.05). The operation time, the initial time to the ground, the initial walking distance, and the postoperative hospital stay were recorded. At 2, 4, 6, 12, 24, and 48 hours after operation, the numerical rating scale (NRS) score was used to evaluate the rest pain around the knee joint, the quadriceps femoris muscle strength was evaluated by the freehand muscle strength method, and the knee flexion and extension angles were measured.

Results

There was no significant difference in the operation time and initial walking distance between the two groups ( P>0.05); the initial time to the ground and postoperative hospital stay of the study group were significantly shorter than those of the control group ( P<0.05). Except for the 48-hour postoperative NRS score of the study group, which was significantly lower than that of the control group ( P<0.05), there was no significant difference in the NRS scores between the two groups at the remaining time points ( P>0.05). The quadriceps femoris muscle strength from 4 to 24 hours postoperatively and the knee extension angle from 2 to 6 hours postoperatively of the study group were significantly better than those of the control group ( P<0.05); the differences in the quadriceps femoris muscle strength and knee extension and flexion angles between the two groups at the remaining time points were not significant ( P>0.05).

Conclusion

SNB combined with either continuted ACB or continuted FNB can effectively relieve pain in patients after TKA, and compared with combined continuted FNB, combined continuted ACB has less effect on quadriceps femoris muscle strength, and patients have better recovery of knee flexion and extension mobility.

Intelligent Algorithm-Based Ultrasound for Evaluating the Anesthesia and Nursing Intervention for Elderly Patients with Femoral Intertrochanteric Fractures

This study was aimed to explore the anesthesia, analgesia, and nursing intervention scheme for elderly patients undergoing the operation of intertrochanteric fracture of femur under the guidance of ultrasound optimized by blind deblurring algorithm. Fifty elderly patients undergoing intertrochanteric femoral surgery were randomly enrolled into control group (tracheal intubation intravenous anesthesia + routine nursing) and experimental group (ultrasound-guided nerve block anesthesia + comprehensive nursing based on blind deblurring algorithm), with 25 patients in each group. The effects of anesthesia and recovery were evaluated in the two groups. The results showed that the image evaluation index of blind deblurring algorithm was superior to other algorithms (BM3D, DnCNN, and Red-Net), which improved the quality of ultrasound imaging and was more conducive to intraoperative anesthesia guidance. At the beginning and end of intubation and operation, the fluctuation range of mean arterial pressure (MAP) and heart rate (HR) in the experimental group was lower than that in the control group. The maintenance time of sensory and motor anesthesia block (7.53 ± 1.47 h, 5.45 ± 1.36 h) was longer than that of control group (3.38 ± 1.26 h, 3.02 ± 1.31 h). Visual Analogue Scale/Score (VAS) scores at 6 h, 12 h, and 24 h after surgery were lower than those in the control group. The effective rate of nursing and the incidence of complications (92% and 8%) were better than the control group (80% and 16%), and the difference was statistically significant (P < 0.05). In summary, the optimization effect of blind deblurring algorithm was good, which can improve the quality of ultrasound-guided surgery and help in the smooth implementation of surgery. Moreover, nerve block anesthesia and comprehensive nursing were of great value in postoperative analgesia and recovery of patients.