| Objectives To investigate the effect of combined anesthesia,which is transversus abdominis plane(TAP)block combined with general anesthesia,on postoperative nausea and vomiting(PONV)and the quality of early recovery in elderly patients undergoing laparoscopic inguinal herniorrhaphy.Methods A total of 60 elderly patients who underwent unilateral transabdominal preperitoneal repair(TAPP)under general anesthesia in our hospital were randomly divided into two groups: general anesthesia group(control group),general anesthesia combined with TAP group(experimental group),30 patients each.The vital signs were compared between the two groups before induction(T0),during incision(T1),during hernia sac dissection(T2),during suture(T3),and at the end of operation(T4),the conditions of nausea and vomiting and static and dynamic VAS scores of postoperative pain were compared between the two groups 0～2h after the operation(T5),2～6h after the operation(T6),6～12h after the operation(T7),and 12～24h after the operation(T8),the dosage of anaesthetic drugs,recovery time and extubation time were recorded,Qo R-40 scoring was performed 1d before the operation,2d after the operation,and 3d after the operation,respectively,and the number of PCA pump compressions,time to first ambulation,time to oral intake,anal exsufflation time,postoperative hospital stay,patients’ satisfaction and related adverse effects were recorded over a period of 48 h.Results 1 Results of hemodynamic parameters,the HR and MAP at each time point from T1 to T4 have significantly differences(all P<0.05),HR of the experimental group was significantly lower than that of control group,MAP was higher than that of control group at T1 and T2 and T4,was lower than that at T3.2 The dosage of anaesthetic drugs,recovery time and extubation time were significantly lower in the experimental group than in the control group(all P<0.05).3 Results of nausea and vomiting,the VAS scores of nausea at all time points from T5 to T7 were significantly lower in the experimental group than in the control group,and the number of vomiting cases at T6 was significantly lower in the experimental group than in the control group(all P<0.05).4 Results of postoperative pain,the static and dynamic VAS scores of postoperative pain at all time points from T5 to T8 were significantly lower in the experimental group than in the control group(all P<0.05).5 Results of postoperative,the Qo R-40 scores at 2d and 3d after the operation were higher in the experim ental group than in the control group(all P<0.05).The number of PCA pump compressions,time to first ambulation,time to oral intake,anal exsufflation time,and postoperative hospital stay were lower in the experimental group(all P<0.05).6The experimental group had significantly higher perioperative satisfaction(P<0.05).7Statistical results of related complications,no adverse effects of TAP block were observed in the experimental group,and postoperative complications were not significantly different between the two groups(P>0.05).Conclusions 1 Ultrasound-guided transverse abdominis plane block can be used securely and availably in the whole perioperative analgesia of elderly patients with laparoscopic inguinal hernia repair,the analgesia precise effect is clear,and decreases the incidence of adverse reactions.2 The combination of general anesthesia and TAP block for laparoscopic inguinal herniorrhaphy in elderly patients increases analgesic satisfaction and decreases the incidence of PONV,especially the early onset of PONV.3 The combination of general anesthesia and TAP block for laparoscopic inguinal herniorrhaphy in elderly patients improving the quality of early postoperative recovery and patients’ satisfaction,and is suitable for the application of modern ERAS concept in anesthesia profession.Figure 6;Table 10;Reference 134... |
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