超声引导下腹横肌平面阻滞在老年患者腹股沟疝修补术中的应用

Application of Ultrasound-guided Transverse Abdominal Muscle Plane Block in Inguinal Hernia Repair in Elderly Patients

目的:探讨超声引导下腹横肌平面阻滞在老年患者腹股沟疝修补术中的应用。方法:选择2019年5月-2021年5月于广东医科大学附属第二医院进行治疗的腹股沟疝修补术老年患者80例作为研究对象,以随机数字表法分为观察组(n=40)和对照组(n=40)。观察组使用超声引导下腹横肌平面阻滞(TAPB),对照组使用硬膜外麻醉。比较两组的麻醉优良率、麻醉操作时间、麻醉费用、术后视觉模拟评分(VAS)、喉罩拔除时间、24 h镇痛泵按压次数以及不良反应发生情况。结果:观察组麻醉优良率97.50%(39/40)高于对照组的85.00%(34/40)(P<0.05);观察组麻醉操作时间短于对照组(P<0.05),麻醉费用低于对照组(P<0.05);与对照组比较,术后4、8、12及24 h观察组VAS评分均更低(P<0.05);观察组喉罩拔除时间短于对照组(P<0.05),24 h镇痛泵按压次数显著少于对照组(P<0.05);观察组不良反应发生率为12.50%,低于对照组的32.50%(P<0.05)。结论:在腹股沟疝修补术老年患者中使用超声引导下TAPB效果显著,可有效降低患者术后疼痛。

Objective:To investigate the application of ultrasound-guided transverse abdominal muscle plane block in inguinal hernia repair in elderly patients.Method:A total of 80 cases of elderly patients undergoing inguinal hernia repair in the Second Affiliated Hospital of Guangdong Medical University from May 2019 to May 2021 were selected as the study subjects,they were randomly divided into observation group (n=40) and control group (n=40).The observation group was treated with ultrasound-guided transverse abdominal plane block (TAPB),and the control group was treated with epidural anesthesia.The excellent and good rate of anesthesia,anesthesia operation time,anesthesia cost,postoperative visual analog score (VAS),laryngeal mask extraction time,24 h analgesic pump pressing times and adverse reactions were compared between the two groups.Result:The excellent and good rate of anesthesia in the observation group was 97.50% (39/40),which was higher than 85.00% (34/40) in the control group (P<0.05);the anesthesia operation time of the observation group was shorter than that of the control group (P<0.05),and the anesthesia cost was lower than that of the control group (P<0.05);compared with the control group,the VAS scores of the observation group were lower at 4,8,12 and 24 h after operation (P<0.05);the removal time of laryngeal mask in the observation group was shorter than that in the control group (P<0.05),and the pressing times of analgesic pump in 24 h was significantly less than that in the control group (P<0.05);the incidence of adverse reactions in the observation group was 12.50%,lower than 32.50% in the control group (P<0.05).Conclusion:In elderly patients undergoing inguinal hernia repair,ultrasound-guided TAPB has a significant effect and can effectively reduce postoperative pain.