低剂量七氟醚与羟考酮对腹腔镜腹股沟疝修补术麻醉效果

目的探究低剂量七氟醚与羟考酮对腹腔镜腹股沟疝修补麻醉效果。 方法选取2020年2月至2021年12月在山西省晋城大医院接受腹腔镜腹股沟疝修补术择期手术94例患者，根据手术中麻醉方式的不同分为对照组（47例）和观察组（47例）。2组均以及低剂量七氟醚吸入维持，观察组手术结束前30 min静脉推注盐酸羟考酮；对照组给予舒芬太尼。统计2组患者苏醒时间（停止麻醉至自行睁眼）和清醒时间（自行指鼻），采用视觉模拟评分法（VAS）评价2组患者术后1、6、24 h的疼痛程度，记录2组患者诱导后（T₁）、拔管后（T₂）的平均动脉压（MAP）、心率、血氧饱和度（SpO₂）等应激指标，麻醉前和术后第1天的超敏-C反应蛋白（hs-CRP）、白介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）等炎症因子指标，以及术后不良反应发生情况。 结果观察组麻醉清醒时间、苏醒时间均小于对照组（P<0.05）；观察组患者术后1、6、24 h VAS评分明显低于同期对照组的评分（P<0.05）；与T₁比较，2组患者T₂的MAP和心率均升高，SpO₂降低；观察组T₁、T₂的MAP、心率波动均小于对照组，SpO₂高于对照组（P<0.05）；与麻醉前相比，2组患者术后第1天的各炎症因子指标均显著升高（P<0.05）；且观察组炎症因子指标低于对照组（P<0.05）；观察组总不良反应率（12.77%）低于对照组（29.79%），差异有统计学意义（P<0.05）。 结论低剂量七氟醚联合羟考酮有助于维持体腹腔镜腹股沟疝患者血流动力稳定，有效缓解患者术后疼痛及全身炎症状态，降低机体应激反应和不良反应发生情况。

Effects of low-dose sevoflurane and oxycodone on anesthesia in laparoscopic inguinal hernia repair

ObjectiveTo explore the effect of low-dose sevoflurane and oxycodone on anesthesia in laparoscopic inguinal hernia repair. MethodsA total of 94 patients undergoing elective laparoscopic inguinal hernia repair in Shanxi Jincheng University Hospital from February 2020 to December 2021 were selected as the subjects, and all patients were divided into control group (47 cases) and observation group (47 cases) according to different anesthesia methods. Low-dose sevoflurane inhalation was maintained in both groups. Oxycodone hydrochloride was injected intravenously 30 min before the end of surgery in the observation group. The control group was given sufentanil. The awaking time (from anesthesia to self-opening) and waking time (self-pointing nose) of patients in the two groups were analyzed. Visual analogue scale (VAS) was used to evaluate the pain degree of patients in the two groups at 1, 6, and 24 h after surgery. Stress indexes such as mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO₂) after induction (T₁) and extubation (T₂) were recorded. Inflammatory factors such as hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor -α (TNF-α) before anesthesia and on the first day after surgery, and the incidence of postoperative adverse reactions were also recorded. ResultsThe awaking time and waking time in the observation group were less than those in the control group (P<0.05). Patients in the observation group had significantly lower VAS scores at 1, 6, and 24 h than the control group (P<0.05). Compared with T₁, MAP and HR increased in T₂, and the SpO₂ decreased in both groups. The MAP and HR fluctuations in T₁ and T₂ were lower in the observation group than those in the control group, and SpO₂ was higher than that in the control group (P<0.05). Compared with before anesthesia, the inflammatory factors were significantly increased in the first postoperative day in both groups (P<0.05), and the inflammatory factor index in the observation group was lower than that in the control group (P<0.05). The total adverse reaction rate in the observation group (12.77%) was lower than that in the control group (29.79%), the difference was statistically significant (P<0.05). ConclusionLow-dose sevoflurane combined with oxycodone can help maintain hemodynamic stability in patients undergoing laparoscopic inguinal hernia repairs, effectively relieve postoperative pain and systemic inflammation, and reduce stress reactions and adverse reactions.