不同剂量罗哌卡因联合利多卡因对腹股沟疝无张力修补术后麻醉效果及应激反应的影响

目的探讨不同剂量罗哌卡因联合利多卡因用于腹股沟疝无张力修补术，对患者术后应激反应的影响。 方法选择2020年2至10月内蒙古包钢医院收治的拟在局部麻醉下行腹股沟疝无张力修补手术患者80例，随机分为复合组和对照组，每组各40例。对照组给予0.25%罗哌卡因联合1%利多卡因进行麻醉，复合组给予0.75%罗哌卡因联合1%利多卡因进行麻醉。比较2组患者各时段应激反应指标皮质醇、白细胞介素-6（IL-6）]水平、Ramsay镇静评分、疼痛视觉模拟（VAS）评分、术后患者苏醒状况与术中不良反应情况。 结果术后2组患者术前1 d（T0）时，术后2 h（T1）和术后4 h（T2）的VAS评分与治疗前相比呈下降趋势，术后各时间段复合组的VAS评分比对照组更低（P<0.05）；所有患者应激反应指标对比，T1时2组血清皮质醇、IL-6水平较T0时期增高，但复合组低于对照组（P<0.05），在T2时间段2组患者应激反应指标水平比T1时间段下降，且复合组应激反应水平比对照组低（P<0.05）。与对照组相比，Ramsay镇静评分显著降低（P<0.05）。2组患者术后苏醒情况比较，复合组苏醒时间短于对照组（P<0.05）；术中不良反应发生率复合组（1/40）明显低于对照组（7/40）（P<0.05）。 结论0.75%罗哌卡因联合1%利多卡因对腹股沟疝术后的患者有显著的镇痛效果，可以降低炎症，不良反应少，有临床推广的意义。

Effects of different doses of ropivacaine combined with lidocaine on anesthetic effect and stress response after tensorless inguinal hernia repair

ObjectiveTo investigate the effects of different doses of ropivacaine combined with lidocaine on stress response after inguinal hernia. MethodsA total of 80 patients with tension-free inguinal hernia repair under local anesthesia admitted to Inner Mongolia Baogang Hospital from February to October 2020 were selected and randomly divided into two groups: the compound group and the control group, with 40 cases in each group. The control group was given 0.25% ropivacaine combined with 1% lidocaine for anesthesia, and the compound group was given 0.75% ropivacaine combined with 1% lidocaine for anesthesia. Stress response indexes cortisol, interleukin6 (IL-6)], Ramsay sedation score, visual analogue scale (VAS) score, postoperative recovery, and incidence of intraoperative adverse events were compared between 2 groups at each time. ResultsThe VAS score at 2 hours and 4 hours after surgery was gradually decreased in both groups, and the VAS score of the compound group was lower than the control group at each time point after surgery, and the difference was statistically significant (P<0.05). The comparison of stress response indexes between the two groups showed that the levels of serum cortisol and IL-6 in T1 groups were higher than those in T0 stage, but lower in the compound group than in the control group (P<0.05); the levels of serum cortisol and IL-6 in T2 groups were lower than those in T1 stage, but lower in the compound group than in the control group, with statistical significance (P<0.05). The Ramsay sedation score was significantly decreased compared with the control group, and the difference was statistically significant (P<0.05). The recovery time of patients in the compound group was shorter than that in the control group (P<0.05). The incidence of intraoperative adverse reactions in compound group (1/40) was significantly lower than that in control group (7/40), and the difference was statistically significant (P<0.05). ConclusionThe combination of 0.75% ropivacaine with 1% lidocaine has a significant analgesic effect in patients after inguinal hernia surgery, which can reduce inflammation, has few adverse reactions, and has clinical promotion significance.