局部麻醉在老年腹股沟无张力疝修补中的应用体会

目的探讨老年患者局部麻醉下行腹股沟疝无张力修补术的效果。方法对47例老年腹股沟疝患者，在局部麻醉下行无张力疝修补，对其手术时间、术后尿潴留、术后伤口疼痛、术后下床活动时间、住院费用和术后复发进行研究。结果47例患者平均年龄69．4岁。手术时间为32～56min，无一例术中改全麻插管或硬膜外麻醉。手术操作中无疼痛感42例，轻微疼痛5例。术后阴囊血肿和腹股沟异物感分别为2例和3例，而无尿潴留发生。随访7～21个月，平均15个月，未见复发。结论局部麻醉下行腹股沟疝无张力修补术术后并发症少，可早期下床活动，住院费用低，对全身器官功能影响小，尤其适合老年患者，值得推广。

The clinic experience of local anesthesia in tension-free inguinal hernia repair in aged patients

Objective To study the efficiency of tension-free inguinal hernia repair with local anesthesia rectrospectively. Methods All of the 47 cases were performed tension-free hernioplasty with local anesthesia. And the operation time, postoperative complications such as retention of urine, wound pain, postoperative time staying in bed, hospitalization costs and recurrence were observed. Results The mean age is 69.4 years old in the 47 cases. The local anesthesia operation time was 32 to 56 minutes with no cases converted to epidural anaesthesia. There was no pain in 42 cases and moderate pain in 5 cases. 2 had scrotal hydrocele,3 had foreign body sensation, no retention of urine. The follow-up time was 7 to 21months with no reccurence case. Conclusions The tension-free inguinal hernia repair performed with local anesthesia had many benefits such as shorter postoperative time staying in bed and lower hospitalization costs. And it had lower side effect on the whole body especially in older patients, thus it is worthy to popularize.