术前右美托咪定滴鼻联合腹横肌平面及髂腹下-髂腹股沟神经阻滞对行全身麻醉腹股沟疝手术患者的疗效

Analysis of clinical efficacy and hemodynamic indexes of Dexmedetomidine and TAP-ⅢH nerve block in patients undergoing laparoscopic inguinal hernia surgery

目的探讨术前右美托咪定滴鼻联合腹横肌平面(TAP)及髂腹下-髂腹股沟(ⅢH)神经阻滞对行全身麻醉疝手术患者的疗效及血流动力学等指标的影响。方法选取2015年1月至2018年3月于资阳市第一人民医院收治的81例行腹腔镜下腹股沟疝修补术的患者。随机将其分为研究组和对照组。其中,对照组41例患者采用常规全身麻醉方式,研究组40例患者均在全身麻醉治疗基础上联合右美托咪定滴鼻联合TAP-ⅢH神经阻滞治疗。检测所有患者的麻醉相关指标、血流动力学指标、应激反应指标以及生活质量评分。计量资料及计数资料分别用t检验及连续校正卡方检验。结果术后研究组患者的丙泊酚用量、瑞芬太尼用量、术后视觉模拟评分、躁动现象等麻醉相关指标情况均优于对照组患者,差异具有统计学意义(t=9.242,29.361,15.233;P<0.05;χ~2=4.336,P<0.05)。T2时研究组患者的血流动力学指标、应激反应指标均明显低于对照组,差异具有统计学意义(P<0.05)。术后3 d 2组患者生活质量评分均高于对照组,且研究组患者的生活质量评分更高,差异具有统计学意义较好于对照组患者,差异有统计学意义(P<0.05)。结论术前右美托咪定滴鼻联合TAP-ⅢH神经阻滞对行全身麻醉疝手术患者的疗效更为显著,同时可减轻患者的应激反应并能维持血流动力学的稳定,最终改善预后,值得临床推广应用。

Objective To investigate the analysis of clinical efficacy and hemodynamic indexes of Dexmedetomidine and TAP-ⅢH nerve block in patients undergoing laparoscopic inguinal hernia surgery.Methods Eighty-one cases of laparoscopic inguinal hernia repair in Ziyang First People's Hospital were selected and randomly divided into study group and control group.Forty-one cases in control group were treated with conventional general anesthesia,and 40 cases in study group were treated with dexmedetomidine nasal drip combined with TAP-ⅢH nerve block on the basis of general anesthesia.Anesthesia related indexes,hemodynamics,stress response indicators and quality of life scores of the two groups were compared.Results Postoperative anesthesia related indicators such as propofol dosage,remifentanil dosage,postoperative visual analog score,and agitation in the study group were better than those in the control group,the difference was statistically significant(t=9.242,29.361,15.233;P<0.05;χ2=4.336,P<0.05).At T2,the hemodynamic indexes and stress response indexes of the study group were significantly lower than those of the control group(P<0.05).Three days after operation,the quality of life scores of the two groups were higher than those of the control group,and the quality of life score of the study group was higher,the difference was statistically significant(P<0.05).Conclusion The Dexmedetomidine and TAP-ⅢH nerve block in patients undergoing laparoscopic inguinal hernia surgery is significant,it is worthy of popularization and application.