Abstract:

Objective To observe the effect of ultrasound⁃guided transversus abdominis plane block on stress and early recovery in children after laparoscopic hernia surgery. Methods A total of 60 children aged 2 ~ 4 years who underwent elective laparoscopic hernia surgery were randomly divided into control group（group C，n = 30）and TAPB group（group T，n = 30）. Group C was given general anesthesia with laryngeal mask intubation，and group T was given with 0.5 mL/kg of 0. 25% ropivacaine in transverse abdominis plane block on each side under the guid⁃ ance of ultrasound after general anesthesia. MAP，HR，cortisol（Cor）and blood glucose（Glu）of the two groups were compared at different time points. The time of first postoperative drinking water and hospital stay were record⁃ ed. Postoperative FLACC pain score，autonomic activity and complications were compared. Results Compared with group C，MAP and HR of group T were significantly decreased at T2，while Cor and Glu were significantly decreased at T1 and T2（P < 0.05）. The time of first postoperative drinking water and hospital stay in group T were significantly shorter（P < 0.05）. The FLACC pain scores at 2，4，8 and 12 h were significantly decreased in T group. The first recovery time of ibuprofen was significantly delayed，and the accumulative dosage and frequency of ibuprofen were significantly decreased（P < 0.05）. The proportion of independent sitting up and standing up in group T was higher than that in group C at 4，8 and 12 h after operation，while the incidence of agitation in group T was significantly reduced（P < 0.05）. Conclusion The application of ultrasound⁃guided transversus abdominis plane block based on ERAS concept in laparoscopic hernia repair in children was feasible and effective，which could enhance postoperative analgesia effect，reduce stress response，promote early postoperative activity and eat⁃ ing，and accelerate postoperative recovery.

Key words: transversus abdominis plane block,  , ultrasound ?guided,  , enhanced recovery after surgery,  , pediatric laparoscopic hernia,  , stress,  , early rehabilitation