目的

分析七氟醚与异丙酚联合氯胺酮麻醉在腹腔镜经腹腹膜前疝修补术中的镇静镇痛效果及安全性。

方法

选定汉川市人民医院2019 年3 月至2021 年3 月住院治疗的86 例腹股沟疝患者，通过随机数表法分为2组，每组患者43 例。对照组患者采用异丙酚＋氯胺酮麻醉，试验组患者行七氟醚与异丙酚联合氯胺酮麻醉。对比2组患者不同时间点平均动脉压、心率、应激反应指标、麻醉优良率、麻醉指标、不良反应总发生率。

结果

试验组切皮5 min 后、翻转鞘膜或处理疝囊时、手术结束时的去甲肾上腺素、心率均低于对照组，差异均有统计学意义（P＜0.05）。试验组麻醉诱导时去甲肾上腺素、肾上腺素、肾素低于对照组，差异均有统计学意义（P＜0.05）。试验组麻醉优良率（95.35%）高于对照组（69.77%），试验组起效时间、恢复意识时间、恢复定向力时间均短于对照组，差异均有统计学意义（P＜0.05）。试验组不良反应总发生率与对照组比较，差异无统计学意义（P＞0.05）。

结论

七氟醚与异丙酚联合氯胺酮麻醉应用于疝修补术中，可取得理想的镇痛、镇静效果，维持生命体征稳定，且不良反应发生率较低。

Objective

To analyze the sedative and analgesic effect and safety of sevoflurane and propofol combined with ketamine anesthesia in hernia repair.

Methods

A total of 86 inguinal hernia patients in Hanchuan People's Hospital from March 2019 to March 2021 were selected, and randomly divided into two groups by random number table method, with 43 patients in each group. The control group were given propofol + ketamine anesthesia, and the experimental group were given sevoflurane and propofol combined with ketamine anesthesia. The mean arterial pressure, heart rate, stress response index,excellent and good anesthesia rate, anesthesia index and total incidence of adverse reactions were compared between the two groups at different time points.

Results

At the time points of 5 minutes after skin incision, flipping the sheath or manage the hernia sac, and at the end of the surgery, the norepinephrine and heart rate of the experimental group were lower than those of the control group, and the differences were statistically significant (P＜0.05). The norepinephrine, epinephrine and renin of the experimental group were lower than those of the control group during anesthesia induction, and the differences were statistically significant (P＜0.05). The excellent and good rate of anesthesia in the experimental group (95.35%) was higher than that in the control group (69.77%). The onset time, consciousness recovery time and orientation recovery time in the experimental group were shorter than those in the control group, and the differences were statistically significant (P＜0.05). There was no significant difference in the total incidence of adverse reactions between the experimental group and the control group (P＞0.05).

Conclusion

Sevoflurane and propofol combined with ketamine anesthesia in hernia repair can achieve ideal analgesic and sedative effects,maintain the stability of vital signs, and have a low incidence of adverse reactions.