|
|
|
| Effect of Sevoflurane or Propofol Combined with Remifentanil on Patients Undergoing Laparoscopic Inguinal Hernia Surgery |
| ZHANG Dalei, HOU Guiting, WANG Xin, et al |
| Suzhou Hospital Affiliated to Anhui Medical University, Suzhou Anhui 234000, China |
|
|
|
|
Abstract Objective: To study the efficacy of remifentanil combined with sevoflurane and propofol in patients with laparoscopic inguinal hernia surgery. Methods: 80 patients with inguinal hernia who underwent laparoscopic surgery in our hospital from August 2018 to August 2020 were selected, according to the tool list of random distribution sequence, they were divided into group A and group B, 40 cases in each group. The group A was given remifentanil combined with sevoflurane for anesthesia maintenance, and group B was given remifentanil combined with propofol for anesthesia maintenance. The perioperative situation, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), steward recovery score after extubation, respiratory quotient (RQs) after skin incision, plasma cortisol, blood glucose and adrenocorticotropic hormone (ACTH) levels before anesthesia and at the end of operation were compared between the two groups, and the incidence of adverse reactions was observed. Results: The recovery time and extubation time in group A were (6.03±1.50)min, (9.34±1.63)min, which were significantly shorter than those in group B (7.28±1.76)min,(12.30±2.04)min, with statistically significant (P<0.05). SBP, DBP, HR, steward wake-up score, RQs, plasma cortisol, blood glucose and ACTH levels of the two groups were statistically significant (P<0.05) and had interaction (P<0.05); SBP, DBP and HR levels at 5 min after intubation (T1), 15 min after artificial pneumoperitoneum (T2), 30 min after artificial pneumoperitoneum (T3) and at the end of operation (T4) in the two groups were higher than those before operation (T0), and the increase degree in group A was less than that in group B (P<0.05); At extubation and 10 minutes after extubation, the steward recovery score of group A was (4. 75 1 ± 50), (5. 21 0 ± 37), which were higher than (4. 22 0 ± 47), (4. 86 0 ± 49), the difference was statistically significant (P<0.05); During the whole operation, the RQs of group B was lower than that of group A, and the RQs of group B was significantly lower than that of group A at 0 ~ 1H (P<0.05). At the end of operation, the levels of plasma cortisol, blood glucose and ACTH in the two groups were significantly higher than those before anesthesia (P<0.05); At the end of operation, the levels of plasma cortisol, blood glucose and ACTH in group B were significantly lower than those in group A (P<0.05). The total adverse reaction rates of group A and group B were 15.00% and 17.50% respectively, and there was no statistical significance (P>0.05). Conclusion: Remifentanil combined with sevoflurane in laparoscopic inguinal hernia surgery has significant anesthetic effect, which helps to ensure stable blood flow, shorten the recovery time and extubation time, improve the quality of recovery, and has good safety. Propofol can significantly reduce the body protein decomposition during anesthesia, play the role of nitrogen saving, and also significantly inhibit the intraoperative stress response.
|
|
|
|
|
|
[1] Berndsen MR,Gudbjartsson T,Berndsen FH.Inguinal hernia - review[J].Laeknabladid,2019,105(9): 385~391.
[2] Muysoms F,Van Cleven S,Kyle-Leinhase I,et al.Robotic-assisted laparoscopic groin hernia repair: observational case-control study on the operative time during the learning curve[J].Surg Endosc,2018,32(12): 4850~4859.
[3] Lee HC,Ryu HG,Chung EJ,et al.Prediction of bispectral index during target-controlled infusion of propofol and remifentanil: a deep learning approach[J].Anesthesiology,2018,128(3): 492~501.
[4] Mongelli F,Ferrario di Tor Vajana A,FitzGerald M,et al.Open and laparoscopic inguinal hernia surgery: a cost analysis[J].Laparoendosc Adv Surg Tech A,2019,29(5): 608~613.
[5] Tomnicki J,Leszko A,Kulis D,et al.Current treatment of the inguinal hernia - the role of the totally extraperitoneal (TEP) hernia repair[J].Folia Med Cracov,2018,58(3): 103~114.
[6] Ilonzo N,Gribben J,Neifert S,et al.Laparoscopic inguinal hernia repair in women: trends,disparities,and postoperative outcomes[J].Am Surg,2019,218(4): 726~729.
[7] Kars MS,Villacres Mori B,Ahn S,et al.Fentanyl versus remifentanil-based TIVA for pediatric scoliosis repair: does it matter[J].Reg Anesth Pain Med,2019,44(6): 627~663.
[8] 孙旺春.丙泊酚或七氟醚复合瑞芬太尼麻醉对腹腔镜子宫全切术患者的麻醉效果[J].河北医学,2018,24(7):1086~1090.
[9] 李超,王冰.瑞芬太尼复合丙泊酚或七氟醚对气腹患者血流动力学指标及呼吸动力学指标影响[J].临床军医杂志,2018,46(1):93~94,96. |
|
|
|
2021, Vol. 27 
