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目的:探讨区域麻醉镇静下超声引导双腹横肌平面阻滞（TAPB）和局部浸润麻醉在老年患者腹股沟疝修补术中的效果比较。方法:选取2019年3—9月中国医科大学附属盛京医院择期行单侧腹股沟疝修补术老年患者60例。将患者按随机数字表法分为两组，采用区域麻醉镇静下超声引导双TAPB（侧路TAPB联合髂腹下/髂腹股沟TAPB）30例（观察组），采用局部浸润麻醉30例（对照组）。观察组采用的局部麻醉药为0.375%罗哌卡因，对照组采用的局部麻醉药为0.5%利多卡因。记录两组麻醉前（Tn 1）、手术切皮时（Tn 2）、打开腹外斜肌腱膜时（Tn 3）、疝囊剥离时（Tn 4）、放置补片时（Tn 5）、缝合腹外斜肌筋膜时（Tn 6）、皮肤切口闭合时（Tn 7）的平均动脉压（MAP）和心率，记录Tn 2~Tn 5及术后2、4、6、12和24 h疼痛视觉模拟评分（VAS）；记录改行全身麻醉、术后需要行补救镇痛以及恶心呕吐、局部麻醉药中毒、穿刺针误入腹腔、心脑血管意外等发生情况。n 结果:两组患者均成功实施了麻醉，并顺利完成手术。观察组和对照组手术时间比较差异无统计学意义[（37.20 ± 6.46）min比（38.03 ± 4.87）min，n P>0.05]。两组Tn 1 MAP和心率比较差异无统计学意义（n P>0.05）；观察组Tn 2~Tn 7 MAP和心率明低于对照组，差异有统计学意义（n P0.05. There were no statistical difference in MAP and heart rate at Tn 1 between 2 groups (n P>0.05). The MAP and heart rate at Tn 2 to Tn 7 in observation group were significantly lower than those in control group, and there were statistical differences (n P<0.05). The VAS at Tn 2 to Tn 5 and 4 to 12 h after operation in observation group was significantly lower than that in control group: (1.87 ± 0.94) scores vs. (4.73 ± 1.11) scores, (1.33 ± 0.24) scores vs. (6.77 ± 1.04) scores, (2.10 ± 0.99) scores vs. (7.30 ± 0.65) scores, (2.39 ± 0.63) scores vs. (5.07 ± 0.87) scores, (2.60 ± 0.17) scores vs. (4.47 ± 0.65) scores, (3.13 ± 0.51) scores vs. (6.32 ± 0.44) scores and (4.28 ± 0.76) scores vs. (6.60 ± 0.57) scores, and there was statistical difference (n P0.05). The rates of general anesthesia and postoperative remedial analgesia in observation group were significantly lower than those in control group: 0 vs. 33.3% (10/30) and 6.7% (2/30) vs. 83.3% (25/30), and there were statistical differences (n P0.05). There were no local anesthetic poisoning, accidental intraperitoneal injection, cardiovascular and cerebrovascular accident in 2 groups.n Conclusions:Compared with local infiltration anesthesia, ultrasound-guided double TAPB under regional anesthesia and sedation can provide complete intraoperative and postoperative analgesia during inguinal hernia repair in elderly patients, with more stable hemodynamics and better comfort.