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中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 181 -185. doi: 10.3877/cma.j.issn.1674-392X.2021.02.016

所属专题: 文献

临床论著

不同麻醉方法在腹股沟疝修补术的效果比较
张丹妮1, 段霞光1, 郝春光1, 支小军1, 黄再青1,()   
  1. 1. 014010 包头,内蒙古包钢医院麻醉科
  • 收稿日期:2020-10-16 出版日期:2021-04-18
  • 通信作者: 黄再青
  • 基金资助:
    内蒙古自治区自然科学基金(2018MS08041)

Comparison of anesthesia effects of different anesthesia methods in inguinal hernia repair

Danni Zhang1, Xiaguang Duan1, Chunguang Hao1, Xiaojun Zhi1, Zaiqing Huang1,()   

  1. 1. Department of Anesthesiology, Inner Mongolia Baogang Hospital, Baotou 014010, Inner Mongolia, China
  • Received:2020-10-16 Published:2021-04-18
  • Corresponding author: Zaiqing Huang
引用本文:

张丹妮, 段霞光, 郝春光, 支小军, 黄再青. 不同麻醉方法在腹股沟疝修补术的效果比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(02): 181-185.

Danni Zhang, Xiaguang Duan, Chunguang Hao, Xiaojun Zhi, Zaiqing Huang. Comparison of anesthesia effects of different anesthesia methods in inguinal hernia repair[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(02): 181-185.

目的

探讨超声引导下的腰方肌阻滞、腹横肌平面阻滞在腹股沟疝修补术的麻醉效果差异。

方法

选择2018年8月至2020年8月在内蒙古包钢医院接受腹股沟疝修补手术治疗的患者56例。28例超声引导下腹横肌平面阻滞的患者作为对照组,28例超声引导下腰方肌阻滞的患者作为观察组。对比2组的血流动力学指标[麻醉前、手术开始、手术15 min、手术30 min的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)]、右美托咪定使用量、利多卡因使用例数、术后4、8、12、24、48 h患者的视觉模拟评分法(VAS)、血清炎性因子指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、术后并发症情况。

结果

2组患者在麻醉前、手术开始、手术15 min、手术30 min的MAP、HR、SpO2水平差异无统计学意义(P>0.05)。2组患者的右美托咪定使用量与利多卡因使用例数差异无统计学意义(P>0.05)。观察组在术后24 h、48 h的VAS评分低于对照组(P<0.05)。2组在术后4、8、12 h的VAS评分差异无统计学意义(P>0.05)。术后1 d,2组的CRP、IL-6、TNF-α均增高(P<0.05),但观察组的CRP、IL-6、TNF-α均低于对照组(P<0.05)。2组术后并发症发生率差异无统计学意义(P>0.05)。

结论

对于接受腹股沟疝修补手术的患者,采用超声引导下的腹横肌平面阻滞和腰方肌阻滞,均可以获得较为理想的麻醉效果,患者的心率和血压等指标在手术过程中均可保持稳定,均具有良好的安全性。腰方肌阻滞在术后可以持续更长时间的镇痛作用,同时更有利于稳定血清炎性因子水平。

Objective

To investigate the difference of anesthesia effect between quadratus lumbarum block and transversus abdominis plane block guided by ultrasound in inguinal hernia repair.

Methods

From August 2018 to August 2020, 56 patients with inguinal hernia repair in Inner Mongolia Baogang Hospital were selected. 28 patients with ultrasound-guided transversus abdominis plane block were served as control group, and 28 patients with ultrasound-guided quadratus lumbarum block were used as observation group. The hemodynamic indexes (MAP, HR, SpO2 before anesthesia, at the beginning of surgery, at 15, 30 minutes during the surgery), dexmedetomidine dosage, cases number of lidocaine used, pain score (VAS) at 4, 8, 12, 24, 48 hours, serum inflammatory factor index [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], and postoperative complications were compared between the two groups.

Results

There were no significant differences in MAP, HR and SpO2 between the two groups before anesthesia, at the beginning of operation, 15 and 30 minutes during operation (P>0.05). There were no significant differences in the dosage of dexmedetomidine used and the number of cases of lidocaine used between the two groups (P>0.05). The VAS score of the observation group at 24 and 48 hours after operation was lower than those of the control group (P<0.05). There were no significant differences in VAS score between the two groups at 4, 8 and 12 hours (P>0.05). The levels of CRP, IL-6 and TNF-α in both groups were increased on the 1st day after operation (P<0.05). However, the levels of CRP, IL-6 and TNF-α in the observation groupat 1st day after operation were lower than those in the control group (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).

Conclusion

For patients undergoing inguinal hernia repair surgery, ultrasound-guided transversus abdominis plane block and quadratus lumbarum block can obtain ideal anesthesia effect. The heart rate and blood pressure data of patients can be maintained stable during the operation, and both have good safety. Quadratus lumbarumblock can last longer analgesic effect after operation, and it is more conducive to stabilize the level of serum inflammatory factors.

表1 2组患者一般临床资料比较
表2 2组患者手术不同时间的平均动脉压比较(mmHg,±s
表3 2组患者手术不同时间的心率比较(次/min,±s
表4 2组患者手术不同时间的血氧饱和度比较(%,±s
表5 2组患者右美托咪定使用量与利多卡因使用例数比较
表6 2组患者术后视觉模拟评分比较(分,±s
表7 2组患者血清炎性因子比较(±s
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