To compare the effects of two transverse abdominis plane (TAP) block methods in geriatric elective inguinal hernia repair.

A total of 90 elderly patients who underwent selective inguinal hernia repair in the Second Hospital of Nanjing, Nanjing University of Chinese Medicine from January 2021 to December 2022 were selected and randomly divided into a control group (45 cases, ultrasound-guided lateral TAP block) and an observation group (45 cases, ultrasound- guided two-point block of the transverse abdominis plane). Perioperative indicators, hemodynamic parameters, analgesic effects and stress indicators were compared between the two groups. Adverse reactions were observed. Additionally, the incidence of anesthesia-related adverse reactions such as nausea and vomiting was monitored.

There was no statistically significant difference in the diameter of hernia ring, operation time, or intraoperative blood loss between the two groups (P>0.05). The postoperative ambulation time and hospital stay of the observation group were shorter than those of the control group (P<0.05). The heart rate and mean arterial pressure (MAP) of both groups decreased 10 minutes after the start of the surgery and at the end of the operation (P<0.05). The heart rate and MAP of the observation group were higher than those of the control group (P<0.05). At 24 hours after surgery, the visual analogue scores (VAS) at rest and during activity in the two groups were lower than those at 6 h and 12 h after surgery, and the VAS scores of pain at rest and during activity in the observation group were significantly lower than those in the control group at 6, 12 and 24 hours after surgery (P<0.05). On days 1 and 3 after the operation, the levels of interleukin (IL)-6 and cortisol in both groups increased significantly, and the levels in the observation group were significantly lower than those in the control group (P<0.05). There was no significant change of insulin level in the observation group on day 1 and day 3 after operation. The insulin level in the control group on day 1 after operation was significantly lower than that before operation, and there was a significant difference as compared with the observation group (P<0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05).

Ultrasound-guided two-point TAP block has the advantages of a good analgesic effect, stable hemodynamics, a mild stress response and few adverse reactions. It can improve the comfort level and safety of elderly patients undergoing inguinal hernia repair, and is beneficial for recovery.