探讨局部神经阻滞联合静脉应用右美托咪定在老年腹股沟疝修补术中的应用效果。

选择2020年6月至2022年6月在安徽省庐江县人民医院接受手术治疗的老年腹股沟疝患者60例。依据随机数字表法分为对照组（局部神经阻滞+静脉应用生理盐水）、试验组（局部神经阻滞+静脉应用右美托咪定），各30例。比较2组不同时间点（麻醉前、麻醉完成时、手术开始时、麻醉后15及30 min）的心率和平均动脉压；麻醉起效和维持时间，镇痛效果；术后静息状态下的疼痛程度，患者对镇痛效果的满意度；术后不良反应情况。

在手术开始时及麻醉后15 min，试验组患者的心率明显低于对照组患者（P<0.05），在其余各时间点，2组患者的心率以及平均动脉压差异无统计学意义（P>0.05）。试验组麻醉起效快于对照组，麻醉维持时间优于对照组（P<0.05）。试验组镇痛效果优于对照组（P<0.05）。试验组术后不同时间点静息状态下疼痛评分均低于对照组（P<0.05）。试验组镇痛满意度评分显著高于对照组（P<0.05）。2组术后各种不良反应差异均无统计学意义（P>0.05）。

局部神经阻滞联合静脉应用右美托咪定对老年腹股沟疝修补术术中麻醉及术后镇疼均有良好效果，但可能会引起患者心率降低。

To explore the application effect of local nerve block combined with intravenous dexmedetomidine in elderly inguinal hernia repair.

Sixty elderly patients with inguinal hernia who received surgical treatment in Lujiang County People's Hospital of Anhui Province from June 2020 to June 2022 were selected. According to the random number table method, all patients were divided into a control group ( local nerve block + intravenous saline ) and an experimental group ( local nerve block + intravenous dexmedetomidine ), 30 cases in each group. Compare the heart rate and mean arterial pressure of patients in the two groups at different time points (before anesthesia, after anesthesia, at the beginning of surgery, and 15 and 30 minutes after anesthesia). The onset time and maintenance time of anesthesia were compared between the two groups. The analgesic effects of the two groups were compared. The pain feelings of patients in the rest state after operation were compared between the two groups. The pain relief satisfaction of the two groups was compared. The postoperative adverse reactions of the two groups were compared.

At the beginning of surgery and 15 min after anesthesia, the heart rate of patients in the experimental group was significantly lower than that of patients in the control group (P<0.05), and the differences in heart rate and mean arterial pressure between the two groups at all other time points were not statistically significant (P>0.05). The onset of anesthesia in experimental group patients was less than that in control group patients, and the maintenance of anesthesia was better than that in control group patients (P<0.05). The analgesic effect of patients in the experimental group was better than that of patients in the control group (P<0.05). The pain scores in the resting state at different time points after surgery were higher in the control group than in the experimental group patients (P<0.05). The analgesic satisfaction scores of patients in the experimental group were significantly higher than those of patients in the control group (P<0.05). The data of all types of postoperative adverse reactions in the 2 groups were not statistically different (P>0.05).

Local nerve block combined with intravenous dexmedetomidine has a good effect on anesthesia and postoperative pain relief in elderly inguinal hernia repair, but may induce a decrease in heart rate in these patients.