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Comparative study on elderly patients with indirect inguinal hernia operation under two different methods of anesthesia |
SUN Lina, ZHAO JunJian |
Operating Room, Tangshan Branch of Hebei Provincial Corps Hospital, Chinese People’s Armed Police Forces, Tangshan 063000, China |
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Abstract Objective To comparatively study the clinical efficacy of elderly indirect inguinal hernia opration under ilioinguinal-iliohypogastric nerve block and combined spinal-epidural anesthesia. Methods This study included sixty ASA Ⅱ-Ⅲ elderly male patients, undergoing high ligation of hernial sac and indirect inguinal hernia repair. The patients were randomly divided into two groups: group of ilioinguinal-iliohypogastric nerve block and group of combined spinal-epidural anesthesia. HR(heart rate), MAP(mean arterial pressure)and SpO2 were measured at 4 time points, entering the operating room, before skin incision, 15 min after incision, and end of operation. Anesthesia proceeding time, average recovery time, anesthesia effect assessment and cases of urinary retention were recorded during and after operation. Results (1) HR, MAP, SpO2 were not significantly different at each time point in both groups(P>0.05). (2) Anesthesia proceeding time and average recovery time in the group of the nerve block were (3.0±0.8) min and (3.5±1.0)h respectively, in the group of combined spinal-epidural anesthesia were (14.8±1.0)min and(9.0±1.3)h respectively,with significant differences(P<0.05). (3) Anesthesia effect assessment: there were 28 cases of grade Ⅰand 2 cases of grade Ⅱ in the group of the nerve block , and 29 cases of grade Ⅰand 1 case of grade Ⅱ in the group of combined spinal-epidural anesthesia, there was no significant differences between the two groups. (4) Cases of urinary retention after operation in the group of nerve block (2 cases) was less than in the group of combined spinal-epidural anesthesia (12 cases)(P<0.05). Conclusions High ligation of hernial sac and indirect inguinal hernia repair for elderly patients under ilioinguinal-iliohypogastric nerve block is characterized by simplicity and safety, good effect, rapid recovery and less complication. It is better than combined spinal-epidural anesthesia.
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Received: 17 December 2014
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[2] |
陈佳慧,任明扬,邓思寒,等. 不同麻醉方式下老年腹股沟疝修补术343例[J/CD] .中华疝和腹壁外科杂志(电子版),2013,7(4):319-322.
|
[1] |
Gultekin F A, Kurukahvecioglu O, Karamercan A, et al. A prospective comparison of local and spinal anesthesia for inguinal hernia repair[J].Hernia,2007,11(2):153-156.
|
[3] |
鄂道香.腹股沟神经-髂腹下神经阻滞在老年腹股沟斜疝手术中的应用[J] .中国医药指南, 2010, 8(36): 111-112.
|
[2] |
陈佳慧,任明扬,邓思寒,等. 不同麻醉方式下老年腹股沟疝修补术343例[J/CD] .中华疝和腹壁外科杂志(电子版),2013,7(4):319-322.
|
[3] |
鄂道香.腹股沟神经-髂腹下神经阻滞在老年腹股沟斜疝手术中的应用[J] .中国医药指南, 2010, 8(36): 111-112.
|
[4] |
张励才.麻醉解剖学[M] .北京: 人民卫生出版社,2000: 129.
|
[5] |
Sanjay P,Woodward A.Inguinal hernia repair:local or general anaesthesia [J].Ann R Coll Surg Engl,2007, 89(5):497-503.
|
[4] |
张励才.麻醉解剖学[M] .北京: 人民卫生出版社,2000: 129.
|
[6] |
郑颖梅,沈跃华,程建新,等.罗比卡因等比重液用于老年病人腰-硬联合阻滞的临床研究 [J]. 临床麻醉学杂志,2005,21(3): 174-176.
|
[7] |
胡海涛,龚志翔,金瑞林,等.髂腹股沟髂腹下神经阻滞在老年患者斜疝手术中的临床应用[J]. 临床麻醉学杂志,2013,29(10): 1009-1010.
|
[5] |
Sanjay P,Woodward A.Inguinal hernia repair:local or general anaesthesia [J].Ann R Coll Surg Engl,2007, 89(5):497-503.
|
[8] |
Nordin P,Zettemtrom H,Gunnarsson U,et al.Local,regional,orgeneral anaesthesia in groin hernia repair:multicentre randomized tria1[J].Lancet,2003,362(9387):853-858.
|
[6] |
郑颖梅,沈跃华,程建新,等.罗比卡因等比重液用于老年病人腰-硬联合阻滞的临床研究 [J]. 临床麻醉学杂志,2005,21(3): 174-176.
|
[7] |
胡海涛,龚志翔,金瑞林,等.髂腹股沟髂腹下神经阻滞在老年患者斜疝手术中的临床应用[J]. 临床麻醉学杂志,2013,29(10): 1009-1010.
|
[8] |
Nordin P,Zettemtrom H,Gunnarsson U,et al.Local,regional,orgeneral anaesthesia in groin hernia repair:multicentre randomized tria1[J].Lancet,2003,362(9387):853-858.
|
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