摘要
目的探讨纳布啡复合丙泊酚用于腹腔镜腹股沟疝修补手术中的麻醉效果及对人体应激反应及炎症因子的影响。方法选择2020年1月至2022年6月,在安徽省马鞍山市人民医院接受腹腔镜经腹腹膜前腹股沟疝修补术(TAPP)治疗的患者80例为研究对象。依据随机数字表法分为对照组、观察组,各40例。2组均采用气管插管全身麻醉,在麻醉诱导过程中对照组联合使用舒芬太尼,观察组联合使用纳布啡。比较2组手术前、切皮时、苏醒时的平均动脉压、心率、血氧饱和度,术后0.5、2、6、12 h的镇痛效果(视觉模拟评分法),麻醉药物诱发的不良反应,术前0.5 h、术后4 h的血清应激反应指标[肾上腺素、去甲肾上腺素(NE)、皮质醇]、血清炎性反应指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]。结果手术前,切皮时,苏醒时的平均动脉压、心率、血氧饱和度2组差异无统计学意义(P>0.05)。VAS评分观察组在术后2、6、12 h均低于对照组(P<0.05),术后0.5 h 2组差异无统计学意义(P>0.05)。2组麻醉药物诱发的不良反应差异无统计学意义(P>0.05)。肾上腺素、NE、皮质醇、IL-6、CRP、TNF-α术前0.5 h 2组差异无统计学意义(P>0.05),术后4 h 2组均增高,且观察组均低于对照组(P<0.05)。结论气管插管全身麻醉下,行TAPP手术,应用纳布啡可获得良好的麻醉效果,降低术后疼痛程度,抑制人体应激反应及炎性反应剧烈程度,且未增加药物不良反应风险。
Objective To investigate the effects of nabuprorphine combined with propofol on anesthetic effect,stress response and inflammatory factors in laparoscopic inguinal hernia repair.Methods From January 2020 to June 2022,80 patients who underwent laparoscopic transabdominal preperitoneal inguinal hernia repair(TAPP)in Ma'anshan People's Hospital of Anhui Province were selected as the research objects.According to the random number table method,they were divided into the control group and the observation group,with 40 cases in each group.Both groups were given general anesthesia by tracheal intubation.During anesthesia induction,the control group was combined with sufentanil,and the observation group was combined with nalbuphine.The mean arterial pressure(MAP),heart rate(HR)and blood oxygen saturation(SPO2)before operation,during skin incision and recovery were compared between the two groups.The analgesic effect(visual analogue scale)at 0.5 h,2 h,6 h and 12 h after operation,and the adverse reactions induced by anesthetics were compared between the two groups.The serum stress response indices[epinephrine,norepinephrine(NE),cortisol]and serum inflammatory response indices[interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]were measured 0.5 h before and 4 h after the operation.Results There were no significant differences in mean arterial pressure,heart rate,or blood oxygen saturation between the two groups before surgery,during the skin incision,and when awake(P>0.05).The VAS scores of the observation group were lower than those of the control group at 2,6,12 h after the operation(P<0.05),0.5 h after operation,there was no significant difference between the two groups(P>0.05).There was no significant difference in the adverse reactions induced by anesthetic drugs between the two groups(P>0.05).There was no significant difference in epinephrine,NE,cortisol,IL-6,CRP and TNF-αbetween the two groups 0.5 h before operation(P>0.05).At 4 hours after the operation,both groups were increased,and the observation group was lower than the control group(P<0.05).Conclusion Under general anesthesia with endotracheal intubation,the application of nalbuphine in TAPP surgery can achieve a good anesthetic effect,reduce the degree of postoperative pain,inhibit the intensity of the stress response and inflammatory response,and does not increase the risk of adverse drug reactions.
作者
李鑫
高元丽
经俊
陆星
马臻
Li Xin;Gao Yuanli;Jing Jun;Lu Xing;Ma Zhen(Department of Anesthesiology,Ma'anshan People's Hospital,Ma'anshan,Anhui 243000,China;Department of Gastrointestinal Surgery,Ma'anshan People's Hospital,Ma'anshan,Anhui 243000,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2023年第2期191-195,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
马鞍山市科技计划项目(YL-2020-12)
关键词
纳布啡
丙泊酚
腹腔镜
疝
腹股沟
麻醉
应激反应
Nabuphine
Propofol
Laparoscope
Hernia,inguinal
Anesthesia
Stress response
作者简介
通通信作者:高元丽,Email:67702710@qq.com
