Abstract:

Objective

To explore the effect of ultrasound-guided transversus abdominis plane block combined with external oblique plane block anesthesia in elderly patients during hernia repair surgery.

Methods

Sixty elderly male patients with inguinal hernia who were admitted to the 901th Hospital of PLA from February 2022 to February 2023 were selected. They were randomly divided into experimental group （n=30） and control group （n=30） according to the random number table method. The experimental group underwent ultrasound-guided transversus abdominis plane block combined with external oblique muscle plane block anesthesia， and the control group underwent local infiltration anesthesia. The changes in heart rate and blood pressure during the operation， the amount of anesthetic liquid， the satisfaction of the patient and the surgeon， the number of additional anesthesia due to pain during the operation， the visual analogue scale （VAS） score during the operation and within 24 hours after the operation， and the adverse reactions after the operation were recorded.

Results

Both groups completed the operation successfully. In the experimental group， the number of patients with intraoperative VAS score ≥4 points， elevated blood pressure， increased heart rate， and additional anesthesia were less than that of the control group （P＜0.05）. There were no significant differences between two groups in the amount of anesthetic liquid， cases with VAS score ≥4 points within 24 hours after operation， and the incidence of postoperative incision fat liquefaction and scrotal edema （P＞0.05）. The number of skin bruising in the operation area of the experimental group was less than that of the control group （P＜0.05），and the satisfaction of patients and surgeons in the experimental group was also better than that of the control group （90.00% vs 66.67%； 85.67% vs 63.33%）， with statistically significant difference （P＜0.05）.

Conclusion

For elderly patients who underwent inguinal hernia repair， the ultrasound-guided transversus abdominis plane block combined with external oblique dual plane block anesthesia can obtain better analgesic effect， fewer intraoperative adverse reaction， and a higher degree of patients and surgeons' satisfaction.

Key words: Hernia, inguinal, Transversus abdominis plane block, External oblique plane block, Herniorrhaphy