探讨超声引导下腹横肌平面阻滞在腹腔镜腹股沟疝手术中的应用效果。

回顾性分析2019年4月至2022年4月，海安市中医院86例腹股沟疝患者的临床资料，均接受腹腔镜疝修补术治疗。依据麻醉方式的不同分为观察组和对照组，每组各43例。对照组行常规麻醉，观察组行超声引导下腹横肌平面阻滞。比较2组患者围手术期相关指标[手术时间、拔管时间、恢复自主呼吸时间、苏醒时间、苏醒质量（Steward苏醒评分）、术后住院时间以及术后芬太尼用量]，麻醉诱导前（T0）、麻醉诱导3 min后（T1）、手术结束时（T2）患者的心率、平均脉动压（MAP）、脉搏血氧饱和度（SpO₂）水平，术后1、6、12 h疼痛视觉模拟评分法（VAS）评分、Ramsay镇静评分及不良反应发生情况。

2组患者手术时间比较，差异无统计学意义（P>0.05）；观察组拔管时间、恢复自主呼吸时间、苏醒时间、住院时间、术后芬太尼用量均少于对照组，Steward评分则高于对照组，差异均有统计学意义（P<0.05）。2组患者T₀时心率、MAP，各时间段SpO₂水平比较，差异无统计学意义（P>0.05）；2组患者T₁、T₂时心率、MAP水平均低于同组T₀时，差异有统计学意义（P<0.05）；2组患者T₂时心率均低于同组T₁时，MAP水平则高于同组T₁时，差异有统计学意义（P<0.05）；观察组T₁、T₂时心率均低于对照组T₁、T₂时，MAP水平则高于对照组T₁、T₂时，差异有统计学意义（P<0.05）。2组患者术后6、12 h的VAS评分、Ramsay镇静评分均低于同组术后1 h，差异有统计学意义（P<0.05）；2组患者术后12 h的VAS评分、Ramsay镇静评分均低于同组术后6 h，差异有统计学意义（P<0.05）。观察组术后1、6、12 h的VAS评分均低于对照组，Ramsay镇静评分则高于对照组，差异有统计学意义（P<0.05）。2组患者不良反应发生情况比较，差异无统计学意义（P>0.05）。

超声引导下腹横肌平面阻滞用于腹腔镜腹股沟疝修补术中，患者苏醒质量好，术后镇痛、镇静效果好，安全性较高。

To explore the application effect of ultrasound-guided transverse abdominal muscle plane block in laparoscopic inguinal hernia surgery.

Retrospective analysis of clinical data of 86 patients with inguinal hernia at Haian Traditional Chinese Medicine Hospital, from April 2019 to April 2022, all of whom underwent laparoscopic hernia repair surgery. They were divided into observation group and control group according to different anesthesia methods, with 43 patients in each group. The control group received routine anesthesia, and the observation group received ultrasound-guided transverse abdominal muscle plane block. The perioperative indexes [operation time, extubation time, recovery time of spontaneous breathing, recovery time, recoveryquality (Steward recovery score), postoperative hospitalization time and postoperative fentanyl dosage] were compared between the two groups. The heart rate, mean pulsatile pressure (MAP) and pulse oxygen saturation (SpO₂) before anesthesia induction (T0), 3 min after anesthesia induction (T1), and at the end of surgery (T2) were compared between the two groups. The visual analogue scale (VAS) score and Ramsay sedation score were compared between the two groups at 1, 6 and 12h after operation, and the adverse reactions of the two groups were compared.

There was no significant difference in operation time between the two groups (P>0.05); The extubation time, recovery time of spontaneous breathing, recovery time, hospitalization time and postoperative fentanyl dosage in the observation group were all lower than those in the control group, and the Steward score was higher than that in the control group, with statistical significance (P<0.05). There was no significant difference between the two groups in heart rate, MAP and SpO₂ levels at T₀ (P>0.05); The levels of heart rate and MAP at T₁ and T₂ in the two groups were lower than those at T₀ in the same group, with statistical significance (P<0.05); The heart rate level at T₂ in both groups was lower than that at T₁ in the same group, and the MAP level was higher than that at T₁ in the same group, with statistical significance (P<0.05); The heart rate level of the observation group at T1 and T2 was lower than that of the control group at T₁ and T₂, and the MAP level was higher than that of the control group at T₁ and T₂, with statistical significance (P<0.05). The VAS score and Ramsay sedation score of the two groups at 6 and 12 h after operation were lower than those of the same group at 1 h after operation, and the difference was statistically significant (P<0.05); The VAS score and Ramsay sedation score of the two groups at 12 h after operation were lower than those of the same group at 6 h after operation (P<0.05). The VAS scores of the observation group at 1, 6 and 12 h after operation were lower than those of the control group, while the Ramsay sedation score were higher than those of the control group, with statistically significant difference (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Ultrasound-guided transverse abdominal muscl plane block is used in laparoscopic inguinal hernia repair, which has good recovery quality, postoperative analgesia and sedation effect, and high safety for patients.