To observe the efficacy of ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in elderly patients ≥70 years old undergoing inguinal hernia repair.

Sixty American Society of AnesthesiologistsⅠ orⅡ patients, aged ≥70 years old, scheduled for elective unilateral inguinal hernia repair under spinal-epidural anesthesia were randomly divided into two groups (n=30 each) using a random number table: control group and test group. Ultrasound-guided TAP block was performed at the end of surgery in the test group. Adverse reactions such as nausea, vomiting, palpitation, dyspnea, dizziness, and sleepiness in the two groups were observed during and after operation. In the test group, the occurrence of adverse events such as blood vessel, nerve, and abdominal organ injury, local anesthetic toxicity, and puncture site infection related to nerve block during and after operation were recorded. Visual analog scale (VAS) scores at rest and cough were recorded at 4, 6, 8, 12, and 24 hours after operation in both groups. Time to ambulation after operation, days of hospitalization after operation, total days of hospitalization, cost of anesthesia, and total cost of hospitalization were recorded. The use of non-steroidal analgesics in the two groups after operation was also recorded.

There were no adverse reactions such as nausea, vomiting, palpitation, dyspnea, dizziness, or sleepiness during and after operation in both groups. All patients in the test group had no injuries of blood vessels, nerves, and abdominal organs, local anesthetic toxicity, or puncture site infection during and after operation. VAS scores at resting state [4 h: (3.8±1.2) points vs (1.6±0.5) points; 6 h: (4.2±1.5) points vs (1.8±0.8) points; 8 h: (4.8±1.5) points vs (2.0±0.7) points; 12 h: (5.2±1.4) points vs (2.2±0.6) points; 24 h: (3.2±?.?) points vs (1.6±0.6) points] and cough [4 h: (3.9±1.3) points vs (1.8±0.8) points; 6 h: (4.6±1.5) points vs (2.0±0.8) points; 8 h: (5.5±1.6) points vs (2.2±0.9) points; 12 h: (5.8±1.8) points vs (2.4±0.8) points; 24 h: (4.6±1.4) points vs (1.8±0.7) points] at different time points were significantly higher in the control group than in the test group (P<0.01). The cost of anesthesia in the test group was significantly higher [(780.06±63.10) yuan vs (566.69±93.23) yuan] than that in control group (P<0.01). There was no significant difference in the total cost of hospitalization between the two groups. The time to ambulation in the test group was earlier [(5.26±1.43) days vs (8.62±1.62) days] than that in the control group (P<0.01), and the number of non-steroidal drugs used in the test group was significantly less (2 vs 28) than that in the control group (P<0.01).

Ultrasound-guided TAP block is a safe and effective method for postoperative analgesia in elderly patients ≥70 years old after open inguinal hernia repair.