局部神经阻滞麻醉在成人腹股沟疝无张力修补术中的应用

Application of local nerve block anesthesia in tension-free repair of adult inguinal hernia

目的探讨局部神经阻滞麻醉在成人腹股沟疝无张力修补术中的应用。方法选择2021年1月至2023年4月眉山市人民医院收治的336例腹股沟疝患者作为研究对象。按照随机数表法将患者分为2组,每组患者168例。患者均采用无张力疝修补术,试验组采用局部神经阻滞麻醉,对照组采用硬膜外麻醉联合腰麻。比较2组患者麻醉及手术时间、术后进食水时间、术后下床时间,术后患者对镇痛效果的满意率及疼痛程度,术后并发症发生情况。结果试验组患者麻醉及手术时间、术后6 h的VAS评分、术后进食水时间及术后下床时间均优于对照组,差异均有统计学意义(P<0.05)。试验组患者术后24 h对镇痛效果满意率高于对照组,差异有统计学意义(P<0.05)。2组患者术后均未发生局部麻醉药中毒及心脑血管意外;2组术后总并发症发生率比较,差异无统计学意义(P>0.05)。结论局部神经阻滞麻醉不仅可以降低手术和麻醉时间、后进食水时间及术后下床时间,还可以提高患者的舒适度和满意度。

Objective To explore the application of local nerve block anesthesia in tension-free repair of adult inguinal hernia.Methods 336 patients with inguinal hernia admitted to Meishan People's Hospital from January 2021 to April 2023 were selected as the study subjects.The patients were randomly divided into 2 groups by random number table method,with 168 patients in each group.All patients underwent tension free hernia repair.The experimental group received local nerve block anesthesia.The control group received epidural anesthesia combined with lumbar anesthesia.The anesthesia and surgical time,postoperative water intake time,postoperative out of bed time,analgesia satisfaction rate,degree of pain,and the incidence of postoperative complications were compared between the two groups.Results The anesthesia and surgical time,visual analogue scale score at 6 hours after surgery,postoperative water intake time,and postoperative out of bed time were better in the experimental than those in the control group,and the differences were statistically significant(P<0.05).The satisfaction rate of patients in the experimental group with analgesic effects 24 hours after surgery was higher than that in the control group,and the difference was statistically significant(P<0.05).No patients experienced local anesthetic poisoning or cardiovascular accidents after surgery in two groups.There was no statistically significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Local nerve block anesthesia can not only reduce the time for surgery,anesthesia,postoperative water intake time,and postoperative out of bed time,but also improve comfort and satisfaction of patients.