To analyze the application of dexmedetomidine combined with different concentrations of ropivacaine local nerve block in tension-free repair in inguinal hernia in elderly patients.

Eighty elderly patients with inguinal hernia admitted to Baogang Hospital of Inner Mongolia from March 2020 to March 2022 were divided into group A and group B, with 40 cases in each group. The method was the random number table method. Group A received 0.1% ropivacaine local nerve block combined with dexmedetomidine intravenous pump anesthesia, and group B received 0.2% ropivacaine local nerve block combined with dexmedetomidine intravenous pump anesthesia. All patients were observed for 7 days after the operation. The vital signs at different time points, pain, sedation, exercise and cognition scores 2h and 24h after operation, serum levels of Tau protein, beta amyloid polypeptide 42 (Aβ42) protein and Tau/Aβ42 before and 7 d after the operation, and the occurrence of adverse reactions 24h after operation of the two groups were analyzed.

The heart rate of the group B at skin incision (T2) was lower than that of room entry (T0), 15 minutes after block (T1) and at the end of operation (T3), and lower than that of the group A (P<0.05), HR at other times, mean arterial pressure, pulse oxygen saturation of the two groups was not statistically significant (P>0.05). Compared with 2h after operation, the scores of visual analogue scale (VAS) and Bromage in the two groups decreased at 24 h after operation, and the score of VAS in group A was lower in the two groups (P<0.05). The score of mini-mental state examination (MMSE) was elevated at 24 h after operation, and the score of group A was higher in both groups (P<0.05). Compared with preoperative, serum levels of Tau protein and Tau/Aβ42 in both groups increased at 7 d after operation, and were lower in group A; Aβ42 protein decreased in both groups at 7d after operation and was higher in group A (P<0.05). At 24h after operation, the incidence of adverse reactions in the group A was lower (7.50% vs 27.50%, P<0.05).

0.1% ropivacaine local nerve block combined with dexmedetomidine intravenous pump anesthesia can stabilize vital signs, relieve pain, and improve cognitive function of elderly patients with tension-free inguinal hernia repair and has higher safety. Analysis of its relationship with regulating Tau protein and Aβ42 protein levels is worthy of further clinical research and application.