目的 探究超声引导下双侧腹横筋膜平面(TFP)阻滞对腹股沟疝修补术患者血流动力学及应激反应的影响。方法 选取广东省高州市人民医院2021年12月—2023年11月收治的100例行腹腔镜腹股沟疝修补术患者作为研究对象,采用随机数字表法将其分为研究组和对照组,每组各50例。对照组选择全身麻醉,研究组在此基础上联合超声引导下双侧TFP阻滞,比较两组患者麻醉药物使用剂量、术后血流动力学指标以及疼痛程度。结果 研究组丙泊酚、瑞芬太尼使用量低于对照组(P<0.05)。手术结束时,两组患者心率(HR)、平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)水平比较,差异均无统计学意义(P>0.05);术后2 h,研究组MAP、HR、SBP、DBP均低于对照组(P<0.05)。两组患者疼痛程度评分在不同时间点(术后2、6、12、24 h)比较,差异均有统计学意义(均P<0.001)。术后2、6、12、24 h,研究组疼痛程度评分均低于对照组(P<0.05)。结论 超声引导下双侧TFP阻滞能有效减少腹股沟疝修补术患者术中麻醉药物使用剂量,减轻其术后疼痛及维持血流动力学稳定。
Objective To investigate the effect of ultrasound-guided bilateral transverse fascia plane (TFP) block on hemodynamics and stress response in patients undergoing inguinal hernia repair. Methods A total of 100 patients who underwent laparoscopic inguinal hernia repair in Gaozhou People's Hospital of Guangdong Province from December 2021 to November 2023 were selected as study subjects. They were divided into a study group and a control group by random number table method, with 50 cases in each group. The control group received general anesthesia, and the study group received combined ultrasound-guided bilateral TFP block. The two groups of patients were compared in terms of anesthesia drug dosage, postoperative hemodynamics, and the degree of pain. Results The dosages of propofol and remifentanilin in the study group were lower than those in the control group (P<0.05). At the end of the operation, the heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) between the two groups were not different (P>0.05). At 2 h after operation, the MAP, HR, SBP, and DBP in the study group were lower than those in the control group (P<0.05). There were statistically significant differences in pain scores between the two groups at different time points (2, 6, 12, and 24 h after surgery) (all P<0.001). At postoperative 2, 6, 12, and 24 h after surgery, the pain scores of the study group were lower than those of the control group (P<0.05). Conclusion Ultrasound-guided bilateral TFP block can effectively reduce the dose of intraoperative anesthetic drugs, relieve postoperative pain, and maintain hemodynamic stability in patients undergoing inguinal hernia repair.
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