超声引导下髂腹股沟-髂腹下神经阻滞复合局部浸润麻醉在腹股沟疝修补术中的应用效果

Application Effect of Ultrasound-guided Ilioinguinal-iliohypogastric Nerve Block Combined with Local Infiltration Anesthesia in Inguinal Herniorrhaphy

目的:分析在腹股沟疝修补术中实施超声引导下髂腹股沟-髂腹下神经阻滞复合局部浸润麻醉的可行性与安全性。方法:选取2020年5月-2022年5月于泉州市第一医院择期行单侧无张力腹股沟疝修补术的82例患者,按随机数字表法分为参照组(n=41)与研究组(n=41)。参照组给予蛛网膜下腔阻滞,研究组给予超声引导下髂腹股沟-髂腹下神经阻滞复合局部浸润麻醉。比较两组不同时点平均动脉压、心率、视觉模拟评分法(VAS)评分,并记录并发症发生率。结果:麻醉前、麻醉后10 min、缝皮时,两组平均动脉压、心率比较,差异均无统计学意义(P>0.05);切皮时,研究组平均动脉压高于参照组(P<0.05),但两组心率比较,差异均无统计学意义(P>0.05)。切皮时、缝皮时,两组VAS评分比较,差异均无统计学意义(P>0.05);游离疝囊时,研究组VAS评分低于参照组(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:在腹股沟疝修补术中,采用超声引导下髂腹股沟-髂腹下神经阻滞复合局部浸润麻醉对血流动力学无明显影响,麻醉效果理想,安全性高。

Objective:To analyze the feasibility and safety of ultrasound-guided ilioinguinal-iliohypogastric nerve block combined with local infiltration anesthesia in inguinal herniorrhaphy.Method:A total of 82 patients underwent elective unilateral tension-free inguinal herniorrhaphy in Quanzhou First Hospital from May 2020 to May 2022 were selected and divided into a reference group(n=41)and a research group(n=41)according to the random number table method.The reference group was given subarachnoid block,and the research group was given ultrasound-guided ilioinguinal-iliohypogastric nerve block combined with local infiltration anesthesia.The mean arterial pressure,heart rate and visual analogue scale(VAS)scores were compared between the two groups at different time points,and the incidence of complications was recorded.Result:There were no significant differences in mean arterial pressure and heart rate between the two groups before anesthesia,10 min after anesthesia and at the time of skin suture(P>0.05).During skin incision,the mean arterial pressure in the research group was higher than that in the research group(P<0.05),but there was no significant difference in heart rate between the two groups(P>0.05).When skin was cut and sewn,there were no significant difference in VAS scores between the two groups(P>0.05).Upon free hernial sac,the VAS scores of the research group was lower than that of the reference group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:In inguinal herniorrhaphy,ultrasound-guided ilioinguinal-iliohypogastric nerve block combined with local infiltration anesthesia has no obvious effect on hemodynamics,and the anesthesia effect is ideal and the safety is high.