纳布啡复合丙泊酚对腹腔镜腹股沟疝修补术的麻醉效果

Anesthetic effect of Naburphin and propofol on laparoscopic inguinal hernia repair and its effect on stress and inflammatory factors

目的观察纳布啡复合丙泊酚对腹腔镜腹股沟疝修补术的麻醉效果,并分析其对患者应激、炎症因子的影响。方法选择2015年10月至2018年10月,广西壮族自治区人民医院行腹腔镜腹股沟疝修补术的182例患者作为研究对象,按随机数字法将其分为2组。研究组患者91例,行钠布啡复合丙泊酚静脉麻醉;对照组患者91例,行芬太尼复合丙泊酚静脉麻醉。对比2组患者的麻醉效果、麻醉起效时间、术后清醒时间以及术后1 d疼痛情况,并通过促甲状腺激素(TSH)与皮质醇(Cor)水平观察患者应激反应,对比炎症因子超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化情况。结果2组患者手术麻醉起效时间与术后清醒时间比较,差异无统计学意义(P>0.05);研究组的术后1 d疼痛评分显著低于对照组,差异有统计学意义(P<0.05)。2组患者术前1 d的hs-CRP、IL-6、TNF-α表达水平比较,差异无统计学意义(P均>0.05);术后1 d研究组的hs-CRP、IL-6、TNF-α表达水平均显著低于对照组,差异有统计学意义(P<0.05)。2组患者术前1 d的TSH、Cor表达水平比较,差异无统计学意义(P均>0.05);术后1 d的TSH表达水平比较,差异无统计学意义(P>0.05),术后1d研究组的Cor表达水平均显著低于对照组,差异有统计学意义(P<0.05)。结论纳布啡复合丙泊酚作为腹腔镜腹股沟疝修补术麻醉方式能取得较好的麻醉效果,并且能减轻患者术后疼痛,减少应激反应与炎症反应,可作为腹腔镜腹股沟修补术的优选麻醉方式。

Objective To observe the anesthetic effect of nalbuphine and propofol on laparoscopic inguinal hernia repair,and to analyze its effects on patients'stress and inflammatory factors.Methods A total of 182 patients who underwent laparoscopic inguinal hernia repair in Guangxi Zhuang Autonomous Region People's hospital from October 2015 to October 2018 were selected as study subjects,and they were divided into two groups according to the random number method.The study group received intravenous sodium anesthesia with propofol and the control group received intravenous anesthesia with fentanyl and propofol.The anesthesia effect,anesthesia onset time,postoperative awakening time,and 1d postoperative pain were compared between the two groups of patients,and the patients'stress response was observed by the levels of thyroid stimulating hormone(TSH)and cortisol(Cor),and the inflammatory factor hypersensitivity Changes of C-reactive protein(hs-CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α).Results There was no significant difference between the onset time of operation anesthesia and postoperative awake time between the two groups(P>0.05),but the pain score at 1d after surgery was significantly lower in the study group than that in the control group,the difference was statistically significant(P<0.05).The expression levels of hs-CRP,IL-6,TNF-α,and Cor in the study group were significantly lower than those in the control group after 1 d,and the differences were statistically significant(P<0.05).Conclusion Nabuphine combined with propofol as an anesthesia method for laparoscopic inguinal hernia repair can achieve better anesthesia effects,and can reduce postoperative pain,reduce stress and inflammatory reactions,and can be used as an optimization for laparoscopic inguinal repair Mode of anesthesia.