关键词: 超声引导, 腹横肌平面阻滞, 髂腹下/髂腹股沟, 腹股沟疝修补术

Abstract: Objective   To explore the effect of application of ultrasound-guided lateral approach combined with iliohypogastric/ilioinguinal transversus abdominis plane(TAP) two-point block in laparoscopic inguinal hernia repair. Methods   88 patients who underwent unilateral inguinal hernia repair in our hospital from January 2021 to April 2022 were enrolled as the study subjects.The patients were divided into observation group (n=44) and control group (n=44) according to the random number table.In the control group,lateral TAP block was used after general anesthesia,and in the observation group,lateral combined iliohypogastric/ilioinguinal TAP two-point block was used after general anesthesia.The volatility of heart rate and mean arterial pressure were  analyzed and compared between the two groups at five time points:skin incision (T1),3 hours after surgery (T2),6 hours after surgery (T3),12 hours after surgery (T4),and 24 hours after surgery (T5),and visual analogue scale (VAS) scores were used to compare the degree of pain at T2-T5 between the two groups,and the satisfaction of anesthetic effect was compared between the two groups. Results   The two groups of patients were successfully completed the operation.In the observation group,the VAS scores at rest at T2-T4 were (2.04±0.55),(2.41±0.57) and (2.95±0.70) points,the VAS scores at activity were (2.82±0.59),(3.16±0.68) and (3.80±0.77) points,in the control group,the VAS scores at rest were (2.32±0.69),(3.29±0.77) and (3.54±1.08) points,and (3.55±0.83),(4.07±0.91) and (4.34±1.05) points at activity,respectively.The VAS scores in the observation group were significantly lower than those in the control group,and the proportion of VAS≥4 points at rest was lower (20.45% VS.47.73%).At T2-T5,the hemodynamics in the observation group were more stable,and the satisfaction rate of anesthetic effect was significantly better than that in the control group (93.18% VS.70.45%),and the above differences were statistically significant (P<0.05). Conclusion   In laparoscopic inguinal hernia repair,the use of TAP two-point block anesthesia has better postoperative analgesia,more stable hemodynamics,and better anesthesia than lateral TAP block.

Key words: ultrasound guidance, transversus abdominis plane block, iliohypogastric/ilioinguinal, inguinal hernia repair