A retrospective study on the treatment of inguinal hernia by ultrasound-guided local nerve block

Abstract

Objective To evaluate the application of ultrasound-guided nerve block in elderly patients undergoing inguinal hernia surgery. Methods A retrospective analysis was carried out of sixty-four elderly male patients who had underwent unilateral inguinal hernia repair under local nerve block anesthesia from June 2014 to June 2016 in Liaocheng People’s Hospital. Twenty-nine patients undergoing ultrasound-guided nerve block were the ultrasound-guided group, meanwhile the 35 cases undergoing anatomia located nerve block were the anatomia located group. Clinical data including anesthesia effects, anesthesia dosage, operation time, pain scores, postoperative complications and recurrence rates were recorded and analyzed. Results All the patients aged over 60 years old, with an average age of (67.5±5.3) years. All operations were completed successfully. The average anesthesia dosage of ultrasound-guided group was (24.3±4.2) mland (24.8±3.7) ml in the anatomia located group, with no significant difference (t=0.491, P=0.625). The average operation time of two groups was (55.2±10.0) min vs (49.3±10.7) min with significant difference (t=2.267, P=0.027). One hour after surgery, the VAS score of the ultrasound-guided group was (2.3±0.8), and two hours after surgery the score was (1.5±1.0), meanwhile the scores of the anatomia located group respectively were (2.6±1.0) and (1.2±1.1), with no statistical significances (t=-1.281, 0.728, P=0.205, 0.470). Six hours after surgery, the VAS scores were (0.4±0.5) vs (1.2±0.9), with statistical significance (t=0.000, P<0.05). There was no difference in anesthesia satisfaction scores between the two groups. No significant postoperative complications were observed in the two groups, with an average follow-up of (33.5± 6.5) months, no recurrence or chronic pain occurred. Conclusions Local nerve block guided by ultrasound shows satisfactory anesthetic effects. Compared with local nerve block under body surface localization, it slightly increases operation time, but does not increase the dosage of local anesthetics, which can extend the postoperative analgesia time. Local nerve block guided by ultrasound is an ideal anesthesia in elderly patients with inguinal hernia and needs to be further promoted. Key words: Hernia, inguinal; Aged; Ultrasonic therapy; Nerve block; Anesthesia