Department of Hernia Surgery, Liaocheng People's Hospital, Affiliated to Shandong First Medical University, Liaocheng, 252000, Shandong, China.
Department of Anesthesiology, Liaocheng People's Hospital, Affiliated to Shandong First Medical University, Liaocheng, 252000, Shandong, China.
Updates Surg. 2024 Aug;76(4):1461-1465. doi: 10.1007/s13304-023-01747-6. Epub 2024 Mar 19.
The clinical characteristics of open hernia repair under local nerve block guided by ultrasound and epidural anesthesia under daytime surgery mode were compared and analyzed, and the safety, rationality and effectiveness of tension-free repair of inguinal hernia in elderly patients under local nerve block guided by ultrasound were discussed. The clinical data of 200 patients who underwent inguinal hernia day surgery in Liaocheng People's Hospital Affiliated to Shandong First Medical University from January 2022 to October 2022 were retrospectively analyzed, including 150 patients who underwent local anesthesia block surgery and 50 patients who underwent epidural surgery. The visual analog score of the ultrasound local anesthesia group was lower than that of the epidural surgery group at 4 h after operation. The time of getting out of bed and postoperative exhaust were shorter than those of epidural operation group. The recovery rate of unrestricted activity 2 weeks after surgery was higher than that in epidural surgery group (P < 0.05). The incidence of postoperative acute urinary retention between the two groups was lower in local ultrasound anesthesia group, and the difference was statistically significant (P < 0.05). The median follow-up time was 4(1-6) months, and the follow-up rate was 100%. Postoperative complications were seroma, wound infection, chronic pain and recurrence, and there was no statistical significance between the two groups (P > 0.05). No serious complications occurred in both groups. Compared with open epidural surgery, ultrasound-guided local nerve block tension-free day surgery in the elderly has the advantages of less pain, faster recovery, and is safe and feasible.
比较并分析了日间手术模式下超声引导下局部神经阻滞与硬膜外麻醉行开放疝修补术的临床特点,探讨了超声引导下局部神经阻滞在老年患者腹股沟疝无张力修补术中的安全性、合理性和有效性。回顾性分析 2022 年 1 月至 2022 年 10 月山东第一医科大学附属聊城市人民医院日间手术行腹股沟疝的 200 例患者的临床资料,其中局部麻醉阻滞手术 150 例,硬膜外手术 50 例。术后 4h 超声局部麻醉组的视觉模拟评分低于硬膜外手术组,下床时间和术后排气时间短于硬膜外手术组,术后 2 周不限活动的恢复率高于硬膜外手术组(P<0.05)。两组术后急性尿潴留发生率比较,局部超声麻醉组较低,差异有统计学意义(P<0.05)。两组患者的中位随访时间为 4(1-6)个月,随访率为 100%。术后并发症为血清肿、伤口感染、慢性疼痛和复发,两组间差异无统计学意义(P>0.05)。两组均未发生严重并发症。与开放式硬膜外手术相比,老年患者超声引导下局部神经阻滞无张力日间手术具有疼痛较轻、恢复较快的优点,且安全可行。