罗哌卡因不同给药方式对老年腹股沟疝无张力修补术患者神经阻滞麻醉效果、镇痛及应激反应的影响

目的分析罗哌卡因不同给药方式对老年腹股沟疝无张力修补术患者神经阻滞麻醉效果、镇痛及应激反应的影响。 方法选择2018年5月至2021年5月于马鞍山市人民医院收治的100例拟行无张力疝修补术的老年腹股沟疝患者作为研究对象，采用随机数字表法将患者分为2组，对照组（50例）采用将罗哌卡因广泛注射于手术区域，观察组（50例）在对照组的基础上进行罗哌卡因周围神经浸润麻醉。分析2组患者的心率、平均动脉压；检测2组患者的应激反应指标；对比2组患者的感觉阻滞起效时间、镇痛持续时间；评估2组患者的视觉模拟评分（VAS）、Ramsay评分；统计2组患者的并发症发生率。 结果2组患者的心率、平均动脉压水平较麻醉前均有明显波动（P<0.05），但组间对比差异无统计学意义（P>0.05）。2组患者的血清白介素6、皮质醇、血糖水平较麻醉前均明显升高（P<0.05），但组间对比差异无统计学意义（P>0.05）。观察组患者的感觉阻滞起效时间明显低于对照组，镇痛持续时间明显高于对照组（P<0.05）。术后2、6 h，观察组患者的VAS评分明显低于对照组，Ramsay评分明显高于对照组（P<0.05）。观察组患者的并发症发生率为6.00%，稍高于对照组的4.00%（P>0.05）。 结论罗哌卡因周围神经浸润麻醉可有效减轻无张力疝修补术患者的应激反应，加速麻醉起效时间，具有镇痛、镇静的作用，并发症发生率较低。

Effects of different administration methods of Ropivacaine on nerve block anesthesia,analgesia and stress response in elderly patients underwent tension-free inguinal hernia repair

ObjectiveTo analyze the effects of different administration methods of ropivacaine on nerve block anesthesia, analgesia and stress response in elderly patients underwent tension-free inguinal hernia repair. MethodsA total of 100 elderly patients with inguinal hernia undergoing tension-free hernia repair in Ma'anshan People's Hospital from May 2018 to May 2021 were selected as the research objects. The patients were divided into two groups by random number table method. The control group (50 cases) was widely injected with ropivacaine in the surgical area. The observation group (50 cases) received ropivacaine peripheral nerve infiltration anesthesia on the basis of the control group. The heart rate (HR) and mean arterial pressure (MAP) of patients in the two groups were analyzed. The stress response indicators of patients in the two groups were detected. The onset time of sensory block and analgesia duration of patients in the two groups were compared. The visual analogue score (VAS) and Ramsay score of patients in the two groups were evaluated, and the incidence of complications in the two groups was analyzed. ResultsAfter operation, HR and MAP levels in 2 groups fluctuated significantly compared with those before anesthesia (P<0.05). However, there was no statistical significance between 2 groups (P>0.05). The levels of serum IL-6, Cor and Glu in 2 groups were significantly higher than before anesthesia (P<0.05). However, there was no statistical significance between 2 groups (P>0.05). The onset time of sensory block in observation group was significantly shorter than that in control group, and the duration of analgesia were significantly longer than that in control group (P<0.05). At 2 h and 6h after operation, the VAS scores of observation group were significantly lower than those in the control group, Ramsay scores were significantly higher than control group (P<0.05). The complication rate in observation group was 6.00%, slightly higher than that in control group (4.00%) (P>0.05). ConclusionRopivacaine peripheral nerve infiltration anesthesia can effectively reduce the stress response of patients with tension-free hernia repair, accelerate the effective time of anesthesia, have analgesic and sedative effects, and the incidence of complications is low.