超声引导下两种不同定位法神经阻滞在老年斜疝手术应用中的比较

Comparisom of ultrasound -guided nerve blocks with two different positioning methods in elderly patients undergoing hernia surgery

目的比较超声引导下分别以旋髂深动脉定位和神经定位的髂腹股沟一髂腹下神经阻滞在老年斜疝手术中的应用效果。方法择期行斜疝手术患者40例,年龄65~90岁,ASA分级I~Ⅲ级,随机分成2组(n=20)。v组:采用超声引导下以旋髂深动脉定位的髂腹股沟一髂腹下神经阻滞方法;N组:采用超声引导下直接髂腹股沟一髂腹下神经阻滞定位方法。记录麻醉起效时间,术中、术后6h视觉模拟评分(VAS评分),麻醉满意度以及尿潴留、误入血管等并发症的发生情况。结果2组麻醉起效时间比较差异无统计学意义;2组术中、术后6h VAS评分比较差异无统计学意义;2组术后麻醉满意度评分比较差异无统计学意义;2组均未发生误人血管、尿潴留等并发症。结论超声下以旋髂深动脉定位的神经阻滞与直接定位神经的髂腹股沟一髂腹下神经阻滞均能为老年斜疝手术提供安全有效的麻醉。

Objective To compare the application effects of ultrasound guided ilioinguinal-iliohypogastric nerve block with deep iliac circumflex artery positioning and nerve positioning in elderly patients undergoing hernia surgery. Methods A total of 40patients aged 65-90years with ASA I -III and scheduled for elective hernia surgery were ran- domly allocated into two groups(n =20each).Group V received ultrasound-guided ilioinguinaliliohypogastric nerve block positioned with deep iliac circumflex artery;Group N received ultrasound-guided ilioinguinal-iliohypogastric nerve block directly positioned with nerve.The onset time of anesthesia,VAS scores during surgery and at 6h after surgery,anesthesia satisfaction,urinary retention,and the incidence of complications such as straying into vessels were recorded.Results There were no significant differences in the onset time of anesthesia and VAS scores during surgery and at 6h after surgery between the two groups.There was no significant difference in the postoperative anesthesia satisfaction scores between the two groups.No complications such as urinary retention and straying into vessels were observed in the two groups.Conclusions Ultrasound-guided nerve blocks taking deep iliac circumflex artery as the positioning method or ilioinguinal-iliohypogastric nerve as the direct positioning method can provide safe and effective anesthesia in elderly patients undergoing hernia surgery.