Efficacy of general anesthesia combined with ilioinguina-iliohypoabdominal nerve block in laparoscopic hernia repair in elderly patients

doi:10.3877/cma.j.issn.1674-392X.2022.03.007

Abstract

Abstract:

Objective

To compare the effects of general anesthesia combined with ilioinguina-iliohypoabdominal nerve block and general anesthesia in laparoscopic hernia repair in the elderly.

Methods

A total of 70 elderly patients with inguinal hernia admitted to Fuyang People's Hospital from January 2020 to August 2021 were selected to participate in the study. The patients were randomly divided into two groups: observation group (35 cases) received general anesthesia combined with ilioinguina-iliohypoabdominal nerve block, and control group (35 cases) received general anesthesia. Mean arterial pressure (MAP) and heart rate (HR) levels at different time periods were recorded in 2 groups, Ramsay and visual analogue scale (VAS) scores were evaluated immediately, 6 and 12 hours after surgery, respectively, and anesthesia recovery quality and anesthesia effect were analyzed in 2 groups.

Results

At T1, T2 and T3, MAP and HR levels in 2 groups were significantly lower than those in T₀, and MAP and HR levels in the observation group was significantly higher than that in the control group (P<0.05). At 6 h and 12 hours after surgery, Ramsay score of 2 groups was significantly lower than that immediately after surgery, and Ramsay score in the observation group was significantly lower than that in the control group. The VAS scores of the two groups were significantly higher than that immediately after the operation, while the VAS scores of the observation group was significantly lower than that of the control group (P<0.05). After operation, the extubation time, awake time, and time to leave the operation in observation group were significantly lower than those in the control group (P<0.05). The excellent and good rate of anesthesia of the observation group was 97.14%, which was slightly higher than 88.57% of the control group, with no statistically significant difference (P>0.05).

Conclusion

General anesthesia combined with ilioinguina-iliohypoabdominal nerve block can effectively maintain hemodynamic stability and has good sedation, analgesia and anesthetic recovery quality in elderly patients with laparoscopic inguinal hernia repair, which can be a priority choice for elderly patients with laparoscopic inguinal hernia repair.

Key words: Ilioinguino-iliohypoabdominal nerve block, General anesthesia, Laparoscopes, Herniorrhaphy, Hernia, inguinal

Huihui Li, Ning Cai, Shuangshuang Guan, Kang Yang, Zhongxin Li. Efficacy of general anesthesia combined with ilioinguina-iliohypoabdominal nerve block in laparoscopic hernia repair in elderly patients[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(03): 278-281.

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References 17

[1]	Chaló D, Pedrosa S, Gouveia S, et al. Propofol TCI reductions do not attenuate significant falls in cardiac output associated with anesthesia induction and knee-chest positioning in spinal surgery[J]. J Neurosurg Anesthesiol, 2020, 32(2): 147-155.
[2]	Bruce ES, Hotonu SA, McHoney M. Comparison of postoperative pain and analgesic requirements between laparoscopic and open hernia repair in children[J]. World J Surg, 2021, 45(12): 3609-3615.
[3]	濮健峰, 王梅芳, 潘四磊, 等. 超声引导下以旋髂深动脉为标记的髂腹股沟-髂腹下神经阻滞在老年斜疝手术中的应用[J]. 临床麻醉学杂志, 2017, 33(10): 974-976.
[4]	温宽宏. 静吸复合麻醉与全凭静脉麻醉对老年妇科腹腔镜手术患者麻醉效果比较研究[J/OL]. 心血管外科杂志(电子版), 2020, 9(1): 135-136.
[5]	张莉花. 用七氟烷与瑞芬太尼对接受腹腔镜手术的腹股沟疝患儿进行静吸复合麻醉的效果及安全性[J]. 当代医药论丛, 2020, 18(2): 68-69.
[6]	陈宝霞, 林程程, 郑晓彬. 全身麻醉复合腰硬联合麻醉对腹腔镜手术患者术后疼痛程度与麻醉复苏的影响[J]. 中国医刊, 2020, 55(11): 1238-1241.
[7]	方建国. 静吸复合全身麻醉与腰硬联合麻醉在腹股沟疝患者采用腹腔镜手术治疗的对比研究[J]. 中国医药指南, 2018, 16(16): 180-181.
[8]	Shan SH, Chen YF, Moss HE, et al. Predicting risk of perioperative ischemic optic neuropathy in spine fusion surgery: a cohort study using the national inpatient sample[J]. Anesth Analg, 2020, 130(4): 967-974.
[9]	Liu ZC, Yang RS. Comparison of subxiphoid and intercostal uniportal thoracoscopic thymectomy for nonmyasthenic early-stage thymoma: a retrospective single-center propensity-score matching analysis[J]. Thorac Cardiovasc Surg, 2021, 69(2): 173-180.
[10]	Luzzi L, Corzani R, Ghisalberti M, et al. Robotic surgery vs. open surgery for thymectomy, a retrospective case-match study[J]. J Robot Surg, 2021, 15(3): 375-379.
[11]	吕志排, 雷鸣, 王举. 丙泊酚复合瑞芬太尼靶控输注麻醉对腹腔镜子宫肌瘤剔除术患者术中血流动力学及术后苏醒质量的影响[J]. 河南外科学杂志, 2020, 26(1): 64-66.
[12]	覃兆军, 占乐云, 向春艳, 等. 右美托咪定混合罗哌卡因超声引导下髂腹股沟神经及髂腹下神经阻滞在老年腹股沟疝修补术的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2017, 11(6): 460-464.
[13]	吴雷. 超声引导下髂腹股沟-髂腹下神经阻滞在高龄老年患者无张力疝手术的应用分析[J]. 现代诊断与治疗, 2018, 29(6): 944-946.
[14]	袁堂战, 郭会文, 蒋珂. 局麻与腰硬联合麻醉下李金斯坦腹股沟疝修补术的效果比较[J]. 当代医学, 2018, 24(4): 42-43.
[15]	杨宁, 左明章, 孟小燕, 等. 超声引导下髂腹股沟-髂腹下神经阻滞联合局部浸润麻醉在老年患者腹股沟疝中的应用[J]. 中国临床医生杂志, 2017, 45(3): 48-51.
[16]	韩蓓, 许日昇, 汪洪. 超声引导下髂腹股沟-髂腹下神经阻滞在老年腹股沟疝手术中的应用及其安全性评价[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(3): 276-280.
[17]	纪健, 李亚春, 鲁应军, 等. 超声引导下髂腹股沟-髂腹下神经阻滞在老年腹股沟疝手术中应用效果及安全性分析[J]. 解放军预防医学杂志, 2019, 37(10): 8-9.

组别	例数	T0	T1	T2	T3
观察组	35	85.23±3.49	81.88±3.25^#	82.52±2.56^#	84.23±3.46^#
对照组	35	85.13±3.31	76.49±2.02^#	78.86±2.37^#	80.77±4.21^#
t值		0.12	8.33	6.21	3.76
P值		0.90	<0.001	<0.001	<0.001

组别	例数	T0	T1	T2	T3
观察组	35	85.23±3.49	81.88±3.25^#	82.52±2.56^#	84.23±3.46^#
对照组	35	85.13±3.31	76.49±2.02^#	78.86±2.37^#	80.77±4.21^#
t值		0.12	8.33	6.21	3.76
P值		0.90	<0.001	<0.001	<0.001

组别	例数	T0	T1	T2	T3
观察组	35	72.32±3.47	68.75±2.45^#	70.59±2.57^#	71.25±3.13^#
对照组	35	72.31±3.71	64.44±2.32^#	66.47±2.46^#	68.68±2.27^#
t值		0.01	7.56	6.85	3.93
P值		0.99	<0.001	<0.001	<0.001

组别	例数	T0	T1	T2	T3
观察组	35	72.32±3.47	68.75±2.45^#	70.59±2.57^#	71.25±3.13^#
对照组	35	72.31±3.71	64.44±2.32^#	66.47±2.46^#	68.68±2.27^#
t值		0.01	7.56	6.85	3.93
P值		0.99	<0.001	<0.001	<0.001

组别	例数	术后即刻	术后6 h	术后12 h
观察组	35	5.23±0.42	2.63±0.45^#	2.11±0.33^#
对照组	35	5.25±0.41	3.49±0.72^#	2.82±0.62^#
t值		0.20	5.99	5.98
P值		0.84	<0.001	<0.001

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