Objective To explore the effect of iliohypognstric-ilioinguinal nerve block with ultrasonic guidance on anesthesia of day-case inguinal hernia repair.Methods Sixty patients undergoing day-case inguinal hernia repair with iliohypognstric-ilioinguinal nerve block were enrolled from March 1,2014 to December 31,2016 at Beijng Anzhen Hospital,Capital Medical University and randomly divided into the traditional nerve block group(group C) and ultrasound-guided nerve block group(group U),with 30 cases in each group.Mean arteria1 pressure(MAP),heart rate(HR) and the score of Visual Analogue Scale(VAS) were recorded at skin incision (T1),while pulling the hernia sac(T2),during skin suture (T3) and 6,12 h after surgery (T4,T5).Times of additional local anesthesia and occurrences of adverse reactions were recorded.Results MAP,HR and VAS score in group U were significantly lower than those in group C at T1 and T2 [(102 ± 10) mmHg vs (110 ± 12) mmHg,(98 ± 8) mmHg vs (105 ± 9) mmHg,(68 ± 5) times/min vs (75 ± 7) times/min,(63 ± 3) times/min vs (70 ± 6) times/min,(1.3 ± 0.3) points vs (2.3 ± 0.4) points,(2.0 ± 0.5) points vs (2.9 ± 0.6) points] (P ＜ 0.05).The number of times of additional local anesthesia in group U was significantly less than that in group C[1 (3.3％) vs 6 (20.0％)] (P＜0.05).Group C had 3 cases of nausea and 3 cases of vomiting;group U had 1 case of nausea and 1 case of vomiting;there was no significant difference of adverse reaction rate between groups(P ＞ 0.05).Conclusion Ultrasound-guided iliohypognstric-ilioinguinal nerve block has good effects on intraoperative hemodynamics and postoperative anesthesia in aged patients with day-case inguinal hernia repair.%目的 探讨超声引导髂腹下-髂腹股沟神经阻滞在日间疝修补术中的应用效果.方法 选取2014年3月1日至2016年12月31日在首都医科大学附属北京安贞医院于髂腹下-髂腹殷沟神经阻滞下行腹股沟无张力疝修补日间手术的患者60例.完全随机分为传统神经阻滞组(C组)和超声引导神经阻滞组(U组),各30例.分别于切皮(T1)、游离疝囊(T2)、缝皮(T3)、术后6 h(T4)、术后12 h(T5)时记录平均动脉压(MAP)、心率、疼痛视觉模拟量表(VAS)评分.记录术中局部麻醉药物追加次数,术中及术后局部麻醉药物中毒、局部血肿、恶心、呕吐和呼吸抑制等不良反应的发生情况.结果 U组T1、T2时MAP、心率和VAS评分均明显低于C组,差异均有统计学意义[(102±10) mmHg(1 mmHg =0.133 kPa)比(110±12) mmHg、(98±8)mmHg比(105 ±9)mmHg、(68±5)次/min比(75±7)次/min、(63-3)次/min比(70±6)次/min、(1.3±0.3)分比(2.3±0.4)分、(2.0±0.5)分比(2.9±0.6)分](均P＜0.05).U组术中局部麻醉药物追加次数明显少于C组,差异有统计学意义[1次(3.3％)比6次(20.0％)](P＜0.05).C组术后恶心、呕吐各3例,U组术后恶心、呕吐各1例,未出现其他不良反应,2组不良反应发生率差异无统计学意义(P＞0.05).结论 超声引导髂腹下-髂腹股沟神经阻滞可安全应用于年龄较大患者日间疝修补术,术中血流动力学平稳,术后镇痛效果良好.
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