TAP和INB对腹腔镜下疝气修补术患者的麻醉效果分析

Analysis of Anesthesia Effect of TAP and INB on Patients Undergoing Laparoscopic Hernia Repair

目的探讨全麻复合腹横肌平面阻滞(TAP)和髂腹下髂腹股沟神经阻滞(INB)对腹腔镜下疝气修补术患者的麻醉效果。方法前瞻性选择2021年6月—2022年5月在靖江市中医院就诊的80例腹腔镜下疝气修补术患者为研究对象,以随机数表法分为研究组、对照组,每组40例。对照组实行TAP,研究组采用INB麻醉,比较两组麻醉疗效、麻醉前后体征指标[血压(MAP)、心率(HR)、血氧饱和度(SpO2)]、不良反应发生情况以及麻醉指标(苏醒时间、麻醉后疼痛评分、芬太尼用量、定向力恢复时间)。结果研究组麻醉有效率高于对照组,差异有统计学意义(P<0.05);两组患者神经阻滞前MAP、HR、SpO2比较,差异无统计学意义(P>0.05),两组患者神经阻滞后2 min MAP、HR均降低,并且研究组患者MAP、HR低于对照组,差异有统计学意义(P<0.05),两组患者SpO2比较,差异无统计学意义(P>0.05);研究组不良反应发生率显著低于对照组,差异有统计学意义(P<0.05);研究组苏醒时间、麻醉后镇痛评分、芬太尼用量、定向力恢复时间均短于或少于对照组,差异有统计学意义(P<0.05)。结论针对腹腔镜下疝气修补术患者采取INB,麻醉效果稳定,患者体征指标平稳,不易出现不良反应,值得临床应用。

Objective To investigate the effect of general anesthesia combined with transversus abdominis plane block(TAP)and Inferior iliac and inguinal nerve block(INB)on patients undergoing laparoscopic hernia repair.Methods From June 2021 to May 2022,80 patients with laparoscopic hernia repair who were treated in Jingjiang Hospital of Traditional Chinese Medicine were prospectively selected as the research objects,and they were divided into the study group(n=40)and the control group by random number table method(n=40).The control group was given TAP,and the study group was given INB anesthesia.To compare the efficacy of the two groups,the physical signs[blood pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2)],adverse reactions and anesthesia indicators(wake time,pain score after anesthesia,amount of fentanyl,time of directional force recovery).Results The anesthesia rate of anesthesia in the study group was higher than that in the control group(P<0.05).There was no difference in MAP,HR,and SpO2 sign indicators between the two groups(P>0.05),MAP and HR decreased 2 min after nerve block in the two groups,and the study group were lower than the control group(P<0.05),and no significant difference between SpO2 indicators(P>0.05).After comparison,the incidence of adverse reactions in the study group was significantly lower than that in the control group group(P<0.05).The recovery time,post-anesthesia analgesia score,fentanyl dosage,and directional force recovery time were all shorter or less than that of the control group(P<0.05).Conclusion Ilioinguinal nerve block can be used in laparoscopic hernia repair.The anesthesia effect is stable,the patient's physique index is stable,and the incidence of side effects is small,which is worthy of application.