七氟醚联合右美托咪定硬膜外麻醉对腹股沟疝修补术患儿苏醒质量、氧化应激和炎症状态的影响

Effects of Sevoflurane Combined with Dexmedetomidine Epidural Anesthesia on Recovery Quality,Oxidative Stress and Inflammatory State in Children Undergoing Inguinal Hernia Repair

目的:观察七氟醚联合右美托咪定硬膜外麻醉对腹股沟疝修补术患儿苏醒质量、氧化应激和炎症状态的影响。方法:选择2021年6月~2023年6月石家庄市妇幼保健院收治的行腹腔镜腹股沟疝修补术患儿124例。根据随机数字表法,将患儿分为对照组和观察组,均62例,分别接受七氟醚和硬膜外麻醉和七氟醚联合右美托咪定硬膜外麻醉。对比两组血流动力学指标、苏醒质量、炎症因子、氧化应激因子和麻醉相关的不良反应发生情况。结果:插管时(T1)~手术结束后(T2)时间点,与对照组相比,观察组血流动力学指标[心率(HR)、平均动脉压(MAP)]更低(P<0.05)。与对照组相比,观察组的苏醒时间、自主呼吸恢复时间和拔管时间更短(P<0.05)。术后1 d,与对照组相比,观察组炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)]、丙二醛(MDA)更低,超氧化物歧化酶(SOD)更高(P<0.05)。不良反应发生率在对照组(11.29%)和观察组(9.68%)之间对比未见统计学差异(P>0.05)。结论:七氟醚联合右美托咪定硬膜外麻醉用于腹股沟疝修补术患儿,可稳定患儿的血流动力学,提高苏醒质量,减轻氧化应激和炎症状态,疗效确切。

Objective:To observe the effects of sevoflurane combined with dexmedetomidine epidural anesthesia on recovery quality,oxidative stress and inflammatory state in children undergoing inguinal hernia repair.Methods:From June 2021 to June 2023,124 children who underwent laparoscopic inguinal hernia repair in Shijiazhuang Maternal and Child Health Hospital were selected.According to the random number table method,children were divided into control group and observation group,with 62 cases in each group,they received sevoflurane and epidural anesthesia and sevoflurane combined with dexmedetomidine epidural anesthesia respectively.The hemodynamic indexes,recovery quality,inflammatory factors,oxidative stress factors and anesthesia-related adverse reactions were compared between two groups.Results:At the time point of intubation(T1)to the end of operation(T2),compared with control group,the hemodynamic indexes[heart rate(HR),mean arterial pressure(MAP)]in observation group were lower(P<0.05).Compared with control group,the recovery time,spontaneous breathing recovery time and extubation time in observation group were shorter(P<0.05).1 day after operation,compared with control group,the inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)]and malondialdehyde(MDA)in observation group were lower,and superoxide dismutase(SOD)was higher(P<0.05).There was no significant difference in the incidence of adverse reactions between control group(11.29%)and observation group(9.68%)(P>0.05).Conclusion:Sevoflurane combined with dexmedetomidine epidural anesthesia for children with inguinal hernia repair,which can stabilize the hemodynamics of children,improve recovery quality,and reduce oxidative stress and inflammatory state.