探讨瑞芬太尼复合丙泊酚对小儿腹腔镜腹股沟斜疝疝囊高位结扎术血流动力学及麻醉恢复的影响。

本研究为前瞻性随机对照试验。选取2022年1月至2023年12月，阜阳市妇女儿童医院100例腹腔镜小儿腹股沟斜疝疝囊高位结扎术患者为研究对象。按随机数字表法分为对照组（芬太尼复合丙泊酚麻醉，n=50）和试验组（瑞芬太尼复合丙泊酚麻醉，n=50）。比较两组麻醉诱导前（T₁）、气管插管后（T₂）、手术结束时（T₃）、气管拔管时（T₄）的血流动力学[心率、平均动脉压（MAP）]、应激反应指标（肾上腺素、皮质醇）。记录两组患儿术后苏醒时间及拔管时间，并统计术后不良反应发生情况。

试验组T₂、T₃、T₄的心率、MAP、肾上腺素、皮质醇水平均低于对照组（P<0.05，重复测量方差分析组间效应量偏η²分别为0.150、0.121、0.094、0.086）。试验组苏醒及拔管时间均短于对照组，不良反应总发生率低于对照组，差异均有统计学意义（P<0.05）。

瑞芬太尼复合丙泊酚用于小儿腹腔镜腹股沟斜疝疝囊高位结扎术，能稳定血流动力学、减轻应激反应、降低不良反应发生率，提升麻醉安全性与术后恢复质量。

To explore the effects of remifentanil combined with propofol for total intravenous anesthesia on the hemodynamic status and anesthesia recovery quality of children undergoing laparoscopic high ligation of hernial sac for indirect inguinal hernia.

This was a prospective randomized controlled trial. A total of 100 children who underwent laparoscopic high ligation of hernial sac for indirect inguinal hernia in Fuyang Women and Children's Hospital from January 2022 to December 2023 were enrolled as the research subjects. They were divided into the control group (receiving fentanyl combined with propofol anesthesia, n=50) and the trial group (receiving remifentanil combined with propofol anesthesia, n=50) according to the random number table method. The hemodynamic parameters [heart rate, mean arterial pressure (MAP)] and stress response indicators [adrenaline, cortisol] before anesthesia induction (T₁), after tracheal intubation (T₂), at the end of the surgery (T₃), and at the time of tracheal extubation (T₄) were compared between the two groups. The postoperative awakening time and extubation time of the children in both groups were recorded, and the postoperative adverse reactions were statistically analyzed.

The heart rate, MAP, adrenaline and cortisol levels of the trial group at time-points T2, T3 and T4 were significantly lower than those of the control group (P<0.05, the between-group effect sizes (partial η²) of repeated measures variance analysis were 0.150, 0.121, 0.094, and 0.086, respectively). The recovery time and extubation time of the trial group were both shorter than those of the control group, and the incidence of adverse reactions was lower than that of the control group (P<0.05).

Remifentanil combined with propofol for total intravenous anesthesia in pediatric laparoscopic high ligation of hernial sac for indirect inguinal hernia can stabilize hemodynamics, reduce stress responses, and minimize adverse reactions, thereby enhancing anesthesia safety and postoperative recovery quality.