To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair...To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair,54 old patients(aged 60-96years,ASAⅠ-Ⅲ)with indirect hernia were enrolled and scheduled for unilateral tensiofree herniorrhaphy.Patients were grouped randomly to receive either USGⅡ/IHN plus GFN block(Group G)or USGⅡ/IHN block alone(GroupⅠ).The intraoperative visual analogue scale(VAS)scores were recorded at skin incision,at spermatic cord/round ligament traction and at sac ligation.The resting and dynamic VAS scores were recorded postoperatively.The requirements of extra sedatives and analgesics for intra-and postoperative analgesia were assessed.Occurrence of complications of the block,postoperative nausea and vomiting and femoral nerve palsy was also reported.Both groups showed similar sensory block.When stretching spermatic cord/round ligament,the patients in group G had significantly lower VAS scores than in group.And group G used much fewer adjuvant sedatives and analgesics to achieve adequate anaesthesia.In addition,group G was presented with better intraoperative anaesthesia and lower postoperative dynamic VAS scores at all time points tested.No significant difference was found in the postoperative requirement of rescue medication.Both groups showed no complications related to the block and group G reported no femoral nerve palsy.The addition of GFN block toⅡ/IHN block improves the quality of perioperative anesthesia and analgesia in the elderly and reduces the consumption of extra sedatives and analgesics during the surgery.展开更多
We report two high risk patients undergoing inguinal herniorraphy and testicular biopsy under ultrasound-guided ilioinguinal/iliohypogastric and genitofemoral nerve blocks. The addition of the genitofemoral nerve bloc...We report two high risk patients undergoing inguinal herniorraphy and testicular biopsy under ultrasound-guided ilioinguinal/iliohypogastric and genitofemoral nerve blocks. The addition of the genitofemoral nerve block may enhance the ilioinguinal/iliohypogastric block to achieve complete anesthesia and thus avoid general and neuraxial anesthesia related hypotension that may be detrimental in patients with low cardiac reserve.展开更多
Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free...Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method,with 35 cases each.The control group underwent infiltration of local anesthesia(LA),and the study group added with IINB.The visual analogue scale(VAS)scores of the two groups of patients were compared.Results:The VAS score of the study group when pulling the hernia sac was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:IINB has good analgesic effect in tensionfree inguinal hernia repair in elderly patients,and it is worth promoting.展开更多
Objective: To compare surgical outcomes of acute acetabular transverse fracture using ilioinguinal and Stoppa approach. Methods: Twenty five patients who managed with ilioinguinal approach (group A) at a mean follow-u...Objective: To compare surgical outcomes of acute acetabular transverse fracture using ilioinguinal and Stoppa approach. Methods: Twenty five patients who managed with ilioinguinal approach (group A) at a mean follow-up of (32.3±4.6) mo and 30 patients who managed with Stoppa approach (group B) at a mean follow-up of (29.7±3.8) mo were prospectively reviewed. The study was approved by the hospital ethical review committee (IRB approval no: 0189-2007). Patients were called for routine follow up and follow-up durations were set. End points of the study were: (1) blood loss was measured intraoperatively by measuring the blood loss in the suction drain and counting blood stained gauze and postoperatively by assessing hemoglobin after 6 h of surgery;(2) functional outcome was demonstrated using the Harris hip score;(3) reduction quality and radiological results were demonstrated by Matta scoring system. Results: Mean blood loss (intraoperatively +postoperatively) was (1 175.8±310.2) mL and (1 115.7±285.1) mL in patients operated with ilioinguinal and Stoppa approach, respectively. Mean operative time was (242.3±60.8) min and (198.9±50.3) min in patients operated with ilioinguinal and Stoppa approach, respectively. Functional outcome, radiological outcome and reduction quality showed no significant difference between two approaches. Complication rate was 36.0% in group A (9 patients) and 13.3% in group B (4 patients). Conclusions: Our study concludes that Stoppa approach allows less blood loss and operative time with fewer complications.展开更多
BACKGROUND In daily life and work,there are more and more patients with trauma to the hand,which often results in skin and soft tissue defects.Although there are many repair methods,the function and appearance of the ...BACKGROUND In daily life and work,there are more and more patients with trauma to the hand,which often results in skin and soft tissue defects.Although there are many repair methods,the function and appearance of the fingers will be adversely affected if the repair is inadequate.CASE SUMMARY In the present report we describe an 18-year-old male patient whose right hand was mangled by a machine.X-ray imaging showed that a right hand bone(middle finger)was absent and the alignment was poor.After hospitalization,he was diagnosed with a severe right hand injury,skin and soft tissue defects,partial finger defects,and a skin degloving injury.He underwent reconstructive surgery with anterolateral thigh and ilioinguinal flaps.After two repair operations,satisfactory results were obtained,including good fracture healing,good skin flap shape,and good wrist joint function.CONCLUSION This case highlights the good effect of anterolateral thigh and ilioinguinal flaps repair technique on severe palm injury.展开更多
目的:探讨髂腹股沟入路、改良Stoppa入路和腹直肌旁入路治疗骨盆髋臼骨折的疗效。方法:回顾性分析2020年8月至2022年8月在本院收治的骨盆髋臼骨折患者资料,依照手术治疗方案不同分为三组,即选择髂腹股沟入路病人为A组,选择改良Stoppa入...目的:探讨髂腹股沟入路、改良Stoppa入路和腹直肌旁入路治疗骨盆髋臼骨折的疗效。方法:回顾性分析2020年8月至2022年8月在本院收治的骨盆髋臼骨折患者资料,依照手术治疗方案不同分为三组,即选择髂腹股沟入路病人为A组,选择改良Stoppa入路病人为B组,选择腹直肌旁入路病人为C组,经倾向性匹配评分法最终得出,A、B组均为50例,C组52例,三组基线资料对比差异无统计学意义(P>0.05)。对比三组一般手术情况、术后住院时间、术后7d骨折复位质量、不同时间点(术前、出院时以及术后6个月末次随访)的髋关节功能(改良Merle D'Aubigne and Postel评分系统)以及术后并发症发生情况。结果:三组显露骨折端时间、术中出血量、术后Hb对比差异有统计学意义(P<0.05),其中B、C组显露时间显著短于A组(P<0.05),术中出血量显著少于A组(P<0.05),术后Hb显著高于A组(P<0.05),B、C组间上述手术指标对比差异无统计学意义(P>0.05);三组术后7d骨折复位质量优良率对比差异无统计学意义(P>0.05),C组的优良率虽高于A、B组,但两两组间对比差异无统计学意义(P>0.05);出院时以及术后6个月末次随访时,三组Postel评分逐渐提高,三组时间点效应对比有统计学意义(P<0.05);三组组间效应以及时间点与组间交互效应对比,差异均无统计学意义(P>0.05),三组出院时及术后6个月末次随访时Postel评分均高于术前(P<0.05);三组术后总并发症率对比差异有统计学意义(P<0.05),其中C组显著低于A组(9.62%vs36.00%,P<0.05)。结论:3种手术入路的钢板内固定术治疗骨盆髋臼骨折均能达到良好骨折复位质量,恢复髋关节功能,但改良Stoppa入路和腹直肌旁入路术中显露时间、出血量及术后Hb效果优于髂腹股沟入路,而腹直肌旁入路的骨折复位优良率高于其他2种入路,且并发症更少。展开更多
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、...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。展开更多
文摘To evaluate the anesthetic effect of ultrasound-guided(USG)ilioinguinal/iliohypogastric nerve(Ⅱ/IHN)block combined with genital branch of genitofemoral nerve(GFN)block in the elderly undergoing inguinal hernia repair,54 old patients(aged 60-96years,ASAⅠ-Ⅲ)with indirect hernia were enrolled and scheduled for unilateral tensiofree herniorrhaphy.Patients were grouped randomly to receive either USGⅡ/IHN plus GFN block(Group G)or USGⅡ/IHN block alone(GroupⅠ).The intraoperative visual analogue scale(VAS)scores were recorded at skin incision,at spermatic cord/round ligament traction and at sac ligation.The resting and dynamic VAS scores were recorded postoperatively.The requirements of extra sedatives and analgesics for intra-and postoperative analgesia were assessed.Occurrence of complications of the block,postoperative nausea and vomiting and femoral nerve palsy was also reported.Both groups showed similar sensory block.When stretching spermatic cord/round ligament,the patients in group G had significantly lower VAS scores than in group.And group G used much fewer adjuvant sedatives and analgesics to achieve adequate anaesthesia.In addition,group G was presented with better intraoperative anaesthesia and lower postoperative dynamic VAS scores at all time points tested.No significant difference was found in the postoperative requirement of rescue medication.Both groups showed no complications related to the block and group G reported no femoral nerve palsy.The addition of GFN block toⅡ/IHN block improves the quality of perioperative anesthesia and analgesia in the elderly and reduces the consumption of extra sedatives and analgesics during the surgery.
文摘We report two high risk patients undergoing inguinal herniorraphy and testicular biopsy under ultrasound-guided ilioinguinal/iliohypogastric and genitofemoral nerve blocks. The addition of the genitofemoral nerve block may enhance the ilioinguinal/iliohypogastric block to achieve complete anesthesia and thus avoid general and neuraxial anesthesia related hypotension that may be detrimental in patients with low cardiac reserve.
文摘Objective:To explore the value of ultrasound-guided ilioinguinal and iliohypogastric nerve block(IINB)in tension-free inguinal hernia repair in elderly patients.Methods:A total of 70 elderly patients with tension-free inguinal hernia repair who treated in the hospital from April 2018 to November 2019 were selected and divided into two groups according to the random number table method,with 35 cases each.The control group underwent infiltration of local anesthesia(LA),and the study group added with IINB.The visual analogue scale(VAS)scores of the two groups of patients were compared.Results:The VAS score of the study group when pulling the hernia sac was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:IINB has good analgesic effect in tensionfree inguinal hernia repair in elderly patients,and it is worth promoting.
文摘Objective: To compare surgical outcomes of acute acetabular transverse fracture using ilioinguinal and Stoppa approach. Methods: Twenty five patients who managed with ilioinguinal approach (group A) at a mean follow-up of (32.3±4.6) mo and 30 patients who managed with Stoppa approach (group B) at a mean follow-up of (29.7±3.8) mo were prospectively reviewed. The study was approved by the hospital ethical review committee (IRB approval no: 0189-2007). Patients were called for routine follow up and follow-up durations were set. End points of the study were: (1) blood loss was measured intraoperatively by measuring the blood loss in the suction drain and counting blood stained gauze and postoperatively by assessing hemoglobin after 6 h of surgery;(2) functional outcome was demonstrated using the Harris hip score;(3) reduction quality and radiological results were demonstrated by Matta scoring system. Results: Mean blood loss (intraoperatively +postoperatively) was (1 175.8±310.2) mL and (1 115.7±285.1) mL in patients operated with ilioinguinal and Stoppa approach, respectively. Mean operative time was (242.3±60.8) min and (198.9±50.3) min in patients operated with ilioinguinal and Stoppa approach, respectively. Functional outcome, radiological outcome and reduction quality showed no significant difference between two approaches. Complication rate was 36.0% in group A (9 patients) and 13.3% in group B (4 patients). Conclusions: Our study concludes that Stoppa approach allows less blood loss and operative time with fewer complications.
文摘BACKGROUND In daily life and work,there are more and more patients with trauma to the hand,which often results in skin and soft tissue defects.Although there are many repair methods,the function and appearance of the fingers will be adversely affected if the repair is inadequate.CASE SUMMARY In the present report we describe an 18-year-old male patient whose right hand was mangled by a machine.X-ray imaging showed that a right hand bone(middle finger)was absent and the alignment was poor.After hospitalization,he was diagnosed with a severe right hand injury,skin and soft tissue defects,partial finger defects,and a skin degloving injury.He underwent reconstructive surgery with anterolateral thigh and ilioinguinal flaps.After two repair operations,satisfactory results were obtained,including good fracture healing,good skin flap shape,and good wrist joint function.CONCLUSION This case highlights the good effect of anterolateral thigh and ilioinguinal flaps repair technique on severe palm injury.
文摘目的:探讨髂腹股沟入路、改良Stoppa入路和腹直肌旁入路治疗骨盆髋臼骨折的疗效。方法:回顾性分析2020年8月至2022年8月在本院收治的骨盆髋臼骨折患者资料,依照手术治疗方案不同分为三组,即选择髂腹股沟入路病人为A组,选择改良Stoppa入路病人为B组,选择腹直肌旁入路病人为C组,经倾向性匹配评分法最终得出,A、B组均为50例,C组52例,三组基线资料对比差异无统计学意义(P>0.05)。对比三组一般手术情况、术后住院时间、术后7d骨折复位质量、不同时间点(术前、出院时以及术后6个月末次随访)的髋关节功能(改良Merle D'Aubigne and Postel评分系统)以及术后并发症发生情况。结果:三组显露骨折端时间、术中出血量、术后Hb对比差异有统计学意义(P<0.05),其中B、C组显露时间显著短于A组(P<0.05),术中出血量显著少于A组(P<0.05),术后Hb显著高于A组(P<0.05),B、C组间上述手术指标对比差异无统计学意义(P>0.05);三组术后7d骨折复位质量优良率对比差异无统计学意义(P>0.05),C组的优良率虽高于A、B组,但两两组间对比差异无统计学意义(P>0.05);出院时以及术后6个月末次随访时,三组Postel评分逐渐提高,三组时间点效应对比有统计学意义(P<0.05);三组组间效应以及时间点与组间交互效应对比,差异均无统计学意义(P>0.05),三组出院时及术后6个月末次随访时Postel评分均高于术前(P<0.05);三组术后总并发症率对比差异有统计学意义(P<0.05),其中C组显著低于A组(9.62%vs36.00%,P<0.05)。结论:3种手术入路的钢板内固定术治疗骨盆髋臼骨折均能达到良好骨折复位质量,恢复髋关节功能,但改良Stoppa入路和腹直肌旁入路术中显露时间、出血量及术后Hb效果优于髂腹股沟入路,而腹直肌旁入路的骨折复位优良率高于其他2种入路,且并发症更少。
文摘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。
