超声引导下髂腹下/髂腹股沟腹横肌平面阻滞两点阻滞对老年腹股沟疝手术患者镇痛效果的影响  

Effect of ultrasound-guided ilio-hypoabdominalis/ilio-inguinal transversus abdominal plane two-point block on analgesia in elderly patients undergoing inguinal hernia surgery

作　　者：李佳 张阳光 房鑫 左毅 LI Jia;ZHANG Yangguang;FANG Xin;ZUO Yi(Department of Anesthesiology,Wuxi Huishan District Third People's Hospital,Wuxi,Jiangsu 214183,China)

机构地区：[1]无锡市惠山区第三人民医院麻醉科,江苏无锡214183

出　　处：《医药前沿》2025年第11期42-44,48,共4页Journal of Frontiers of Medicine

摘　　要：目的探讨超声引导下髂腹下/髂腹股沟腹横肌平面阻滞(TAP)两点阻滞对老年腹股沟疝手术患者镇痛效果的影响。方法选取2022年6月—2024年6月无锡市惠山区第三人民医院收治的80例老年腹股沟疝手术患者,按照简单随机法(单双号法)将其分为传统组和复合组,每组40例。传统组行全凭静脉麻醉,复合组采用全凭静脉麻醉复合超声引导下的髂腹下/髂腹股沟TAP两点阻滞。比较两组围术期麻醉情况、血流动力学变化情况,术后3、6、12、24 h疼痛情况,术后6、12 h应激指标、麻醉药物不良反应以及谵妄发生率。结果复合组患者的自主呼吸恢复时间、拔除气管导管时间短于传统组,且丙泊酚及瑞芬太尼的用量低于传统组;复合组各时间段心率、平均动脉压低于传统组;术后复合组视觉模拟评分法评分、应激指标及谵妄发生率低于传统组,差异均具有统计学意义(P<0.05)。结论超声引导下髂腹下/髂腹股沟TAP阻滞复合全凭静脉麻醉可有效提高老年腹股沟疝手术患者镇痛效果,稳定血流动力学,且安全性高。Objective To investigate the effect of ultrasound-guided ilio-subabdominal/ilio-inguinal transversus abdominal plane(TAP)two-point block on analgesia in elderly patients undergoing inguinal hernia surgery.Methods A total of 80 elderly patients with inguinal hernia surgery admitted to Wuxi Huishan District Third People's Hospital from June 2022 to June 2024 were selected and divided into traditional group and compound group according to simple random method(odd-even number method),with 40 cases in each group.The traditional group received intravenous anesthesia,and the compound group received intravenous anesthesia and the ultrasound-guided ilio-hypoabdominalis/ilio-inguinal TAP two-point block.Perioperative anesthesia,hemodynamic changes,postoperative pain at 3,6,12 and 24 h,stress index at 6 and 12 h,adverse reactions to anesthesia and incidence of delirium were compared between the two groups.Results The recovery time of spontaneous respiration and tracheal catheter removal in the compound group were shorter than those in the traditional group,and the dosage of propofol and remifentanil were lower than those in the traditional group.Heart rate and mean arterial pressure in the compound group were lower than those in the traditional group.Visual Analogue Scale scores,stress indexes and delirium incidence in the composite group were lower than those in the traditional group,and the differences were statistically significant(P<0.05).Conclusions Ultrasound-guided ilio-hypoabdominalis/ilioinguinal TAP block combined with intravenous anesthesia can effectively improve the analgesic effect in elderly patients undergoing inguinal hernia surgery,stabilize hemodynamics,and have high safety.

关 键 词：腹股沟疝 全凭静脉麻醉 髂腹下神经 髂腹股沟神经 腹横肌平面阻滞 罗哌卡因 镇痛效果 疼痛应激 

分 类 号：R657[医药卫生—外科学]