低流量七氟醚用于腹腔镜下腹股沟疝修补术麻醉中的作用

The Role of Low-flow Sevoflurane in Anesthesia for Laparoscopic Inguinal Hernia Repair

目的分析腹腔镜下腹股沟疝修补术麻醉中使用低流量七氟醚的临床效果。方法选取94例行腹腔镜下腹股沟疝修补术的患者随机分为甲组(47例,低流量七氟醚麻醉)与乙组(47例,氯胺酮麻醉)。对比不同时间点两组患者血流动力学指标、恢复时间、不良反应。结果诱导前两组心率(HR)、收缩压(SP)、舒张压(DP)差异无统计学意义(P> 0.05),气腹前、气腹后5 min、气腹后10 min两组均降低(P <0.05),气腹后5 min低于气腹前(P <0.05),气腹后10 min低于气腹前(P <0.05),与气腹后5 min差异无统计学意义(P> 0.05)。甲组气腹前、气腹后5 min、气腹后10 min高于乙组(P <0.05);甲组苏醒时间、拔管时间、清醒时间短于乙组(P <0.05);甲组不良反应出现率低于乙组(P <0.05)。结论腹腔镜下腹股沟疝修补术麻醉中使用低流量七氟醚可减少对患者血流动力学指标的影响,缩短恢复时间,减少不良反应。

Objective To analyze the clinical effect of low-flow sevoflurane in laparoscopic for laparoscopic inguinal hernia repair. Methods 94 patients underwent laparoscopic inguinal hernia repair were randomly divided into group A (47 patients, low-flow sevoflurane anesthesia) and group B (47 patients, ketamine anesthesia). The hemodynamic parameters at different time points, recovery time and adverse reactions of the two groups were compared. Results The heart rate (HR), systolic blood pressure (SP) and diastolic blood pressure (DP) of the two groups were not significantly different before induction (P > 0.05), of which the two groups were decreased before pneumoperitoneum, 5 mins and 10 mins after pneumoperitoneum (P < 0.05), 5 mins after pneumoperitoneum of two groups were far lower than those before pneumoperitoneum (P < 0.05), 10 mins after pneumoperitoneum of two groups were far lower than those before pneumoperitoneum (P < 0.05), and there were no significant differences between 5 mins and 10 mins of two groups after pneumoperitoneum (P > 0.05). Before the pneumoperitoneum, 5 mins and 10 mins after pneumoperitoneum, of which the group A were significantly higher than those of group B (P < 0.05). The recovery time, extubation time and waking time of group A were much shorter than that of group B (P < 0.05);The incidence of reaction was much lower than that of group B (P < 0.05). Conclusion Low-flow sevoflurane in laparoscopic inguinal hernia repair can reduce the impact on hemodynamic parameters, shorten recovery time and reduce adverse reactions.