腰硬联合麻醉复合丙泊酚用于腔镜下腹股沟斜疝手术的临床观察

目的探讨腰硬联合麻醉复合丙泊酚用于腹股沟斜疝手术的可行性。方法抽取80例于2011年10月-2013年10月在我院行腔镜下腹股沟斜疝手术的患者,美国麻醉师协会（ASA）分级Ⅰ-Ⅱ级,随机分成两组：腰硬联合麻醉复合丙泊酚组,40例（治疗组）,腰硬联合麻醉复合芬太尼、氟哌利多组,40例（对照组）,对比分析两组的治疗效果和不良反应的发生率。结果治疗组的术中MAP、HR、SpO2较术前有明显下降,与同期的对照组数据比较差异有统计学意义（P〈0.01）,从不良反应来看,治疗组的不良反应发生率明显低于对照组,组间比较差异有统计学意义（P〈0.05）。结论腰硬联合麻醉复合丙泊酚可以安全有效地用于腔镜下腹股沟斜疝手术,同时优于芬太尼、氟哌利多,值得在临床上推广。

Clinical observation of combined spinal and epidural anesthesia combined with propofol used in laparoscopic surgery of indirect inguinal hernia

Objective To explore the feasibility of combined spinal and epidural anesthesia combined with propofol used in the surgery of indirect inguinal hernia. Methods 80 patients who received laparoscopic surgery of indirect inguinal hernia in our hospital from October 2011 to October 2013 were selected. They were classified by the American Society of Anesthesiologists（ASA） as status 1 to 2, and randomly allocated to two groups： 40 patients in combined spinal and epidural anesthesia combined with propofol group（treatment group） and 40 patients in combined spinal and epidural anesthesia combined with fentanyl and droperidol（control group）. Curative effect and incidence of adverse events were compared and analyzed between the two groups. Results MAP, HR and SpO2 during the surgery in the treatment group reduced significantly compared to those before the surgery, and the difference was statistically significant compared to the data in the control group during the same period（P〈0.01）. Incidence of adverse events in the treatment group was significantly lower than that in the control group, and the difference between the two groups was statistically significant（P〈0.05）. Conclusion Combined spinal and epidural anesthesia combined with propofol is safe and effective in laparoscopic surgery of indirect inguinal hernia and is better than fentanyl and droperidol, which is worthy of clinical promotion and application.