Analysis of the clinical effect of ultrasound-guided transverse muscle plane block combined with iliohypogastric nerve and ilioinguinal nerve block in elderly patients with inguinal hernia

doi:10.3877/cma.j.issn.1674-392X.2020.06.017

Abstract

Abstract:

Objective

To investigate the clinical effects of ultrasound-guided transverse muscle plane block (TAPB) combined with iliohypogastric nerve and ilioinguinal nerve blocks in elderly patients with inguinal hernia.

Methods

A total of 60 elderly patients with inguinal hernia treated in Pingluo County People's Hospital from October 2017 to October 2018 were selected. The patients were divided into experimental group and control group by random number table method, with 30 patients in each group. The control group received epidural anesthesia, and the experimental group underwent ultrasound-guided TAPB combined with iliohypogastric nerve and ilioinguinal nerve blocks. The clinical parameters and perioperative hemodynamic changes of the two groups were compared, and the postoperative awakening agitation and additional analgesics were recorded, and the patients' agitation and pain were evaluated.

Results

The awakening time in the experimental group was shorter than that in the control group (P<0.05). From before anesthesia to the end of the operation, the levels of HR, MAP, and SpO₂ in the experimental group unchanged (P>0.05). The levels of HR and MAP before the incision, at 10 minutes after the incision and at the end of the surgery in the control group were higher than those before the anesthesia (P<0.05); the HR and MAP levels of the patients in the experimental group at the above time points were lower than those in the control group (P<0.05); The incidence of awakening agitation, the incidence of additional analgesics, and the Cravero score in the experimental group were all lower than those in the control group (P<0.05). The VAS scores of the experimental group were lower than those in the control group at the time of waking, 2 h, 4 h and 8 h after surgery (P<0.05).

Conclusion

The use of TAPB combined with iliohypogastric nerve and ilioinguinal nerve block in elderly patients with inguinal hernia can significantly shorten the awake time and reduce postoperative pain. The hemodynamics of patients during perioperative period is more stable and the sedation effect is good.

Key words: Hernia, inguinal, Elderly patients, Ultrasound guidance, Transverse muscle plane block, Hemodynamics

Rong Tang, Zhuo Liu, Jianping Yang, Ting Yu. Analysis of the clinical effect of ultrasound-guided transverse muscle plane block combined with iliohypogastric nerve and ilioinguinal nerve block in elderly patients with inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(06): 655-659.

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References 17

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组别	例数	手术时间(min)	术中出血量(mL)	苏醒时间(min)
试验组	30	73.47±6.72	28.21±3.45	8.35±1.68
对照组	30	75.59±8.22	29.16±3.06	22.41±3.17
t值		1.094	1.128	21.465
P值		0.279	0.264	<0.001

组别	例数	手术时间(min)	术中出血量(mL)	苏醒时间(min)
试验组	30	73.47±6.72	28.21±3.45	8.35±1.68
对照组	30	75.59±8.22	29.16±3.06	22.41±3.17
t值		1.094	1.128	21.465
P值		0.279	0.264	<0.001

指标	组别	例数	T0	T1	T2	T3
心率(次/min)	试验组	30	78.25±7.31	75.92±7.85	76.79±8.14	77.68±8.50
	对照组	30	77.84±7.76	98.43±12.37^*	97.51±11.49^*	96.56±10.02^*
	F值		0.045	70.829	64.964	61.937
	P值		0.834	<0.001	<0.001	<0.001
平均动脉压(mmHg)	试验组	30	82.49±7.85	85.75±9.62	82.49±7.85	84.06±8.19
	对照组	30	83.37±7.14	93.68±10.43^*	91.74±9.83^*	90.25±9.21^*
	F值		0.206	9.370	16.217	7.568
	P值		0.651	0.003	<0.001	0.008
血氧饱和度(%)	试验组	30	98.78±0.77	99.05±0.58	98.96±0.64	98.83±0.82
	对照组	30	99.04±0.65	99.21±0.73	99.02±0.71	98.67±0.89*
	F值		1.997	0.884	0.118	0.524
	P值		0.163	0.351	0.732	0.472

指标	组别	例数	T0	T1	T2	T3
心率(次/min)	试验组	30	78.25±7.31	75.92±7.85	76.79±8.14	77.68±8.50
	对照组	30	77.84±7.76	98.43±12.37^*	97.51±11.49^*	96.56±10.02^*
	F值		0.045	70.829	64.964	61.937
	P值		0.834	<0.001	<0.001	<0.001
平均动脉压(mmHg)	试验组	30	82.49±7.85	85.75±9.62	82.49±7.85	84.06±8.19
	对照组	30	83.37±7.14	93.68±10.43^*	91.74±9.83^*	90.25±9.21^*
	F值		0.206	9.370	16.217	7.568
	P值		0.651	0.003	<0.001	0.008
血氧饱和度(%)	试验组	30	98.78±0.77	99.05±0.58	98.96±0.64	98.83±0.82
	对照组	30	99.04±0.65	99.21±0.73	99.02±0.71	98.67±0.89*
	F值		1.997	0.884	0.118	0.524
	P值		0.163	0.351	0.732	0.472

指标	例数	苏醒躁动发生率[例(%)]	追加镇痛药发生率[例(%)]	Cravero评分(分，±s)
试验组	30	2(6.67)	1(3.33)	3.68±0.52
对照组	30	10(33.33)	8(26.67)	3.96±0.49
χ²/t值		6.667	4.706*	7.053
P值		0.010	0.030	<0.001

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