观察腹股沟区神经阻滞联合舒芬太尼麻醉在老年腹股沟疝李金斯坦术中的应用效果。

回顾性分析2021年1月至2022年12月，在蒙城县中医院行李金斯坦术治疗的88例老年腹股沟疝患者的临床资料。依收治时间分为观察组（2022年1—12月）和对照组（2021年1—12月）。2组患者均实施李金斯坦术治疗，对照组术中使用腰麻联合硬膜外麻醉镇痛方案，观察组术中使用腹股沟区神经阻滞联合舒芬太尼麻醉镇痛方案。比较2组患者手术基本情况（麻醉起效时间、麻醉维持时间、术后疼痛程度），观察麻醉诱导前、切皮前、切皮后15 min、术毕时2组血液循环情况[血氧饱和度（SpO₂）、心率、平均动脉压（MAP）]，对比术后6 h、12 h、1 d、3 d 2组早期认知功能[采用蒙特利尔认知评估量表（MoCA）评估]，统计术后3 d内2组不良反应。

与对照组比较，观察组麻醉维持时间更长（P<0.05），麻醉起效时间更短、术后疼痛程度更轻（P均<0.05）。切皮前、切皮后15 min、术毕时，观察组患者SpO₂水平低于对照组（P<0.05），心率、MAP水平2组比较差异无统计学意义（P>0.05）。术后6 h、12 h，观察组患者MoCA量表评分低于对照组（P<0.05）；术后1 d、3 d，2组患者MoCA量表评分比较差异无统计学意义（P>0.05）。术后3 d内，观察组不良反应总发生率低于对照组（P<0.05）。

腹股沟区神经阻滞联合舒芬太尼麻醉应用于老年腹股沟疝李金斯坦术，麻醉效果好，血液循环稳定，药物安全性高，但不利于改善患者术后早期认知功能。

To observe the effects of inguinal nerve block combined with sufentanil anesthesia in Lichtenstein repair of elderly inguinal hernia.

Retrospective analysis of the clinical data of 88 elderly patients with inguinal hernia treated with Lichtenstein repair at Mengcheng County Traditional Chinese Medicine Hospital from January 2021 to December 2022. They were divided into an observation group (from January 2022 to December 2022) and a control group (from January 2021 to December 2021) based on the time of admission. All patients were treated with Lichtenstein repair, and the control group was given lumbar anesthesia combined with epidural anesthesia during surgery, the observation group was given inguinal nerve block combined with sufentanil anesthesia during surgery. The basic conditions of operation (onset time of anesthesia, maintenance time of anesthesia, degree of postoperative pain) were compared between the two groups. The blood circulation status [blood oxygen saturation (SpO₂), heart rate (HR), mean arterial pressure (MAP)] were observed before anesthesia induction, before skin incision, at 15 min after skin incision and at the end of surgery. The early cognitive function [Montreal Cognitive Assessment (MoCA)] was compared between the two groups at 6 h, 12 h, 1 d and 3 d after surgery, and the adverse reactions in the two groups within 3 d after surgery were analyzed.

The maintenance time of anesthesia was longer in the observation group than that in the control group (P<0.05), the onset time of anesthesia were shorter and degree of postoperative pain were lower than those in the control group (P<0.05). Before skin incision, at 15 min after skin incision and at the end of surgery, the SpO₂ level in observation group was lower than that in the control group (P<0.05), and there was no significant statistical differences in HR and MAP between the two groups (P>0.05). At 6 and 12 h after surgery, the score of MoCA scale was lower in observation group than that in control group (P<0.05). There was no significant statistical difference in MoCA scale score between the two groups at 1 and 3 d after surgery (P>0.05). The total incidence rate of adverse reactions in observation group within 3 d after surgery was lower than that in control group (P<0.05).

Inguinal nerve block combined with sufentanil anesthesia in elderly patients undergoing Lichtenstein repair has good anesthetic effect, stable blood circulation, and high drug safety, but is not conducive to improving early postoperative cognitive function.