超声引导下髂腹股沟-髂腹下神经阻滞联合局部浸润麻醉用于老年人腹股沟疝无张力修补术中的麻醉效果观察

Anesthesia Effect Observation of Ultrasound-Guided Ilioinguinal Hypogastric Nerve Block Combined with Local Infiltration Anesthesia for Tension-Free Repair of Inguinal Hernia of the Elderly

目的探讨超声引导下髂腹股沟-髂腹下神经阻滞联合局部浸润麻醉用于老年人腹股沟疝无张力修补术中的麻醉效果。方法选择2021年5月—2023年4月本院收治的60例老年人腹股沟疝无张力修补术患者进行研究,按照随机数字表法分为对照组与观察组,每组30例。对照组采用硬膜外麻醉,观察组采用超声引导下髂腹股沟-髂腹下神经阻滞联合局部浸润麻醉,比较两组麻醉效果。结果两组T0时间段的平均动脉压(MAP)、心率(HR)无明显差异(P>0.05),T1、T2、T3时间段时,两组上述指标有明显差异(P<0.05);观察组术中芬太尼、阿托品追加剂量较对照组高,麻醉苏醒时间较对照组短(P<0.05);观察组呼吸抑制、恶心呕吐、心动过缓、尿潴留等麻醉不良反应发生率与对照组比较无明显差异(P>0.05)。结论超声引导下髂腹股沟-髂腹下神经阻滞联合局部浸润麻醉用于老年人腹股沟疝无张力修补术中血流动力学稳定,减少术中麻醉药品追加剂量,且不会增加不良反应发生风险,值得推广。

Objective To explore anesthesia effect of ultrasound-guided ilioinguinal hypogastric nerve block combined with local infiltration anesthesia for tension-free repair of inguinal hernia for the elderly.Methods The paper chose 60 elderly patients with tension-free repair of inguinal hernia from May 2021 to April 2023,and divided them into control group and observation group randomly,with 30 cases in each group.Control group was treated with epidural anesthesia,while observation group with ultrasound-guided iliac inguinal iliac hypogastric nerve block combined with local infiltration anesthesia.Anesthesia effect between two groups was compared.Results There was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between two groups during T0 time period(P>0.05).However,there was significant difference in these indicators between two groups during T1,T2,and T3 time periods(P<0.05).Additional doses of fentanyl and atropine during surgery in observation group were higher than control group,anesthesia recovery time was shorter than control group(P<0.05).There was no significant difference between observation group and control group in incidence of respiratory depression,nausea and vomiting,bradycardia,urinary retention and other adverse reactions to anesthesia(P>0.05).Conclusion Ultrasound guided ilioinguinal iliac hypogastric nerve block combined with local infiltration anesthesia is suitable for tension-free repair of inguinal hernias of elderly with stable hemodynamics,can reduce intraoperative anesthetic dosage,with no increase of adverse reaction risks,which is worthy of promotion.