Ultrasound-guided popliteal sciatic nerve block versus traditional analgesia for early perioperative pain relief in severe chronic lower extremity arterial occlusive disease: A retrospective study.

Abstract

ObjectiveChronic lower extremity arterial occlusive disease (LEAO) presents significant diagnostic and management challenges, often requiring effective perioperative pain management to enhance patient outcomes. This study evaluated the efficacy of ultrasound-guided popliteal sciatic nerve block (PSNB) compared to traditional analgesia in managing early perioperative pain and improving microcirculation in patients with severe LEAO.MethodsThis retrospective, exploratory study involved 92 patients with Fontaine classification III and IV LEAO, treated from January 2021 to December 2022. Patients were divided into two groups: those receiving traditional analgesia with fentanyl patches and those undergoing PSNB. Clinical outcomes assessed included early perioperative pain intensity using the Visual Analogue Scale (VAS), Toe-Brachial Index (TBI), foot temperature (FT), and feet transcutaneous oxygen pressure (FTpO2). Data on tramadol usage and results from lower limb ultrasound post-analgesia were also collected.ResultsPSNB was associated with significantly lower VAS scores and higher TBI, foot temperature, and transcutaneous oxygen pressure compared to traditional analgesia, indicating enhanced pain management and microcirculation. Furthermore, PSNB patients showed a significantly reduced consumption of tramadol and improved collateral circulation in the lower limbs as evaluated on the fifth day post-analgesia.ConclusionPSNB provides superior pain control and enhances microcirculatory outcomes in the early perioperative period for patients with severe LEAO, presenting a promising alternative to traditional analgesic methods. These findings suggest that PSNB has the potential to improve early perioperative management in LEAO, although further research is needed to confirm these results across broader populations.