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已发表论文
超声引导下腹直肌鞘阻滞对单孔腹腔镜小儿腹股沟疝修补术苏醒期镇痛及躁动的影响：一项随机临床试验
Authors Chen A, Hao R, Wang C, Gu C, Xu X
Received 7 May 2025
Accepted for publication 31 October 2025
Published 7 November 2025 Volume 2025:18 Pages 5919—5929
DOI https://doi.org/10.2147/JPR.S533287
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Helen Koechlin
An Chen,1,2 Ruijinlin Hao,3 Chen Wang,4 Can Gu,5 Xingguo Xu5
1Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China; 2Research Institute of Anesthesiology and Perioperative Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Anesthesiology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Department of Anesthesiology, Chinese People’s Liberation Army Navy Specialized Medical Center, Shanghai, People’s Republic of China; 5Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, People’s Republic of China
Correspondence: Xingguo Xu, Department of Anesthesiology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, Jiangsu, 226001, People’s Republic of China, Tel +86 15162771638, Fax +86 051381160318, Email TDFYXXG@126.com
Purpose: Inguinal hernia repair (IHR) is one of the most common pediatric surgeries, particularly in early childhood. Postoperative pain from IHR can cause significant psychological and physiological distress in children. This study investigates the efficacy and safety of ultrasound-guided rectus sheath block (RSB) in managing postoperative pain and emergence agitation (EA) in children undergoing single-incision laparoscopic inguinal hernia repair, aiming to improve strategies for postoperative care.
Patients and Methods: This single-blind, prospectively, randomized controlled trial enrolled 90 pediatric patients who were randomly assigned to three groups, they were respectively the bilateral rectus abdominis sheath block group under ultrasound guidance (Group R), Local anesthesia infiltration group (Group L) and blank control group (Group C). Primary outcomes included the incidence of EA. Secondary outcomes comprised pain scores, opioid consumption, and adverse events, and Pediatric Anesthesia Emergence Delirium (PAED) scales at various postoperative time points.
Results: EA incidence was significantly reduced in Groups R compared to Group C (RR [95% confidence interval] of 0.083 [0.007,0.019], P < 0.05). Extubation time in Group R (RSB) was significantly shorter compared to Group C (P < 0.05). During skin incision, mean arterial pressure (MAP) and heart rate (HR) were lower in Group R than in Groups L and C, with significant differences noted only between Groups R and C (P < 0.05). Postoperative pain scores were significantly reduced in Groups R and L compared to Group C (P < 0.05). Additionally, Group R demonstrated prolonged analgesia and reduced opioid consumption.
Conclusion: Ultrasound-guided RSB is a safe and effective technique for postoperative analgesia in pediatric single-incision laparoscopic inguinal hernia repair. It provides superior pain relief, reduces EA incidence, and minimizes opioid use. These findings suggest that RSB may be a valuable adjunct to general anesthesia for this specific procedure.
Keywords: rectus sheath block, inguinal hernia repair, emergence agitation, postoperative analgesia
1Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, People’s Republic of China; 2Research Institute of Anesthesiology and Perioperative Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Anesthesiology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 4Department of Anesthesiology, Chinese People’s Liberation Army Navy Specialized Medical Center, Shanghai, People’s Republic of China; 5Department of Anesthesiology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, People’s Republic of China
Correspondence: Xingguo Xu, Department of Anesthesiology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, Jiangsu, 226001, People’s Republic of China, Tel +86 15162771638, Fax +86 051381160318, Email TDFYXXG@126.com
Purpose: Inguinal hernia repair (IHR) is one of the most common pediatric surgeries, particularly in early childhood. Postoperative pain from IHR can cause significant psychological and physiological distress in children. This study investigates the efficacy and safety of ultrasound-guided rectus sheath block (RSB) in managing postoperative pain and emergence agitation (EA) in children undergoing single-incision laparoscopic inguinal hernia repair, aiming to improve strategies for postoperative care.
Patients and Methods: This single-blind, prospectively, randomized controlled trial enrolled 90 pediatric patients who were randomly assigned to three groups, they were respectively the bilateral rectus abdominis sheath block group under ultrasound guidance (Group R), Local anesthesia infiltration group (Group L) and blank control group (Group C). Primary outcomes included the incidence of EA. Secondary outcomes comprised pain scores, opioid consumption, and adverse events, and Pediatric Anesthesia Emergence Delirium (PAED) scales at various postoperative time points.
Results: EA incidence was significantly reduced in Groups R compared to Group C (RR [95% confidence interval] of 0.083 [0.007,0.019], P < 0.05). Extubation time in Group R (RSB) was significantly shorter compared to Group C (P < 0.05). During skin incision, mean arterial pressure (MAP) and heart rate (HR) were lower in Group R than in Groups L and C, with significant differences noted only between Groups R and C (P < 0.05). Postoperative pain scores were significantly reduced in Groups R and L compared to Group C (P < 0.05). Additionally, Group R demonstrated prolonged analgesia and reduced opioid consumption.
Conclusion: Ultrasound-guided RSB is a safe and effective technique for postoperative analgesia in pediatric single-incision laparoscopic inguinal hernia repair. It provides superior pain relief, reduces EA incidence, and minimizes opioid use. These findings suggest that RSB may be a valuable adjunct to general anesthesia for this specific procedure.
Keywords: rectus sheath block, inguinal hernia repair, emergence agitation, postoperative analgesia