探讨全身麻醉联合超声引导下髂腹股沟神经阻滞及腹直肌鞘阻滞对腹腔镜下腹股沟疝修补术患者麻醉及镇痛效果的影响。

选择2019年8月至2022年6月在马鞍山市人民医院接受腹腔镜下腹股沟疝修补手术的患者60例作为研究对象。采用随机数字表法进行分组，对照组和观察组各30例，2组均行腹腔镜下完全腹膜外疝修补术（TEP）。对照组采用全身麻醉，观察组采用全身麻醉联合超声引导下髂腹股沟神经阻滞及腹直肌鞘阻滞。比较2组患者麻醉药物使用量（丙泊酚、瑞芬太尼）、生命体征变化情况（手术前、切皮时、苏醒时的平均动脉压、心率、血氧饱和度）、静息和咳嗽状态下术后2、4、8、12、24、48 h的疼痛视觉模拟评分（VAS）。

观察组丙泊酚、瑞芬太尼的使用量低于对照组（P<0.05）。2组患者在手术前、苏醒时的平均动脉压和心率差异无统计学意义（P>0.05），在手术前、切皮时、苏醒时的血氧饱和度差异均无统计学意义（P>0.05）。对照组在切皮时的平均动脉压和心率均高于观察组（P<0.05）。观察组静息及咳嗽状态下术后2、4、8 h的VAS评分均低于对照组（P<0.05），术后12、24、48 h的VAS评分2组差异无统计学意义（P>0.05）。

腹股沟疝患者行TEP治疗时，采用全身麻醉联合超声引导下髂腹股沟神经阻滞及腹直肌鞘阻滞，麻醉效果较全身麻醉更好，可降低麻醉药物用量，减轻术后短期内的疼痛感。

To explore the effect of general anesthesia combined with ultrasound guided ilioinguinal nerve block and rectus abdominis sheath block on anesthesia and analgesia in patients undergoing inguinal hernia repair.

60 patients who underwent inguinal hernia surgery in Ma'anshan People's Hospital from August 2019 to June 2022 were selected as the study subjects. All patients were divided into the control group and the observation group according to the random number table method, with 30 patients in each group. Laparoscopic total extraperitoneal hernia repair (TEP) was performed in both groups. The patients in the control group were given general anesthesia. Patients in the observation group were treated with general anesthesia combined with ultrasound guided ilioinguinal nerve block and rectus abdominis sheath block. The dosage of anesthetic drugs (propofol and remifentanil) was compared between the two groups. The changes of vital signs (mean arterial pressure, heart rate, blood oxygen saturation before operation, at the time of skin incision and at the time of awakening) and the pain in resting state and cough state (pain degree 2 h, 4 h, 8 h, 12 h, 24 h and 48 h after operation) [Visual analog scale (VAS)] were compared between the two groups.

The dosage of propofol and remifentanil in the observation group was lower than that in the control group (P<0.05). There was no significant difference in mean arterial pressure and heart rate between the two groups before surgery and at the time of awakening (P>0.05), and there was no significant difference in blood oxygen saturation between the two groups before operation, at the time of skin incision and at the time of awakening (P>0.05). The mean arterial pressure and heart rate in the control group were higher than those in the observation group at the time of skin incision (P<0.05). The VAS scores in the observation group at rest and cough at 2 h, 4 h, 8 h after operation were lower than those in the control group (P<0.05). There was no significant difference between the two groups in VAS scores at 12 hours, 24 hours, 48 hours after surgery (P>0.05).

For patients with inguinal hernia undergoing TEP repair, the method of general anesthesia combined with ultrasound guided ilioinguinal nerve block and rectus abdominis sheath block had a better anesthetic effect than general anesthesia, which can reduce the use of anesthetic drugs and postoperative short-term pain.