Comparative study of nerve block and spinal-epidural combined anesthesia on hemodynamic parameters in elderly patients with indirect inguinal hernia

Abstract

Objective To compare the effects of nerve block and spinal-epidural combined anesthesia on hemodynamic parameters in elderly patients with indirect inguinal hernia. Methods 86 elderly patients with indirect inguinal hernia treated in general surgery of First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from May 2016 to May 2018 were randomly divided into the spinal-epidural combined group (43 cases) and the nerve block group (43 cases). All patients received elective surgery. The spinal-epidural combined with bupivacaine was given to the patients in the spinal-epidural combined group. The nerve block group was given ropivacaine and dexmedetopyrimidine for nerve block under the guidance of ultrasound. Hemodynamic parameters, anesthetic effect and incidence of adverse reactions were compared between the two groups. Results There were no significant differences in the levels of MAP, RR and SPO2 between the two groups at different time points (P>0.05); the level of HR in the nerve block group at T1 was significantly lower than that in the spinal-epidural combined group (P 0.05). The score of VAS at skin incision in the nerve block group was significantly lower than that in the spinal-epidural group, while the sedation score of Ramsay and sensory block duration in the nerve block group was significantly higher than those in the spinal-epidural group, but the onset time of sensory block in the spinal-epidural combined group was shorter than that in the nerve block group. (P<0.05). After treatment, the incidence of adverse reactions in the nerve block group (6.98%) was significantly lower than that in the spinal-epidural combined group (23.36%) (P<0.05). Conclusion Nerve block is better than spinal-epidural combined anesthesia in elderly patients with indirect inguinal hernia. It can significantly produce better analgesic and sedative effects, and the incidence of adverse reactions is small, which is worthy of clinical promotion and application. Key words: Nerve block; Spinal-epidural combined anesthesia; Elderly patients with indirect inguinal hernia; Hemodynamic parameters; Anesthetic effect; Adverse reactions