Effects of sevoflurane inhalation anesthesia and remifentanil intravenous anesthesia on stress in elderly patients undergoing tension-free hernia repair

doi:10.3877/cma.j.issn.1674-392X.2019.06.017

Abstract

Abstract:

Objective

To compare the effects of sevoflurane inhalation anesthesia and remifentanil intravenous anesthesia on stress in elderly patients undergoing tension-free hernia repair.

Methods

From January 2016 to July 2018, 66 elderly patients undergoing tension-free hernia repair in Nantong Hospital of Traditional Chinese Medicine were randomly divided into the experimental group (33 cases) and the control group (33 cases). The control group received remifentanil intravenous anesthesia, while the experimental group received sevoflurane inhalation anesthesia. The hemodynamics, stress index, anesthesia induction and recovery time were compared between the two groups.

Results

The induction time and recovery time in the experimental group[(67.24±7.03) seconds, (13.53±4.57) minutes]were lower than those in the control group [(71.74±9.34) s, (16.34±5.22) minutes, P<0.05]. There were no significant differences in the levels of Oxygen saturation (SpO₂) between the two groups during anesthesia induction (T1), skin incision (T2), 5 minutes before operation (T3) and recovery (T4) (P>0.05). At T1 and T3 time point, there were no significant differences in the levels of heart rate (HR) and mean arterial pressure (MAP) between the two groups (P>0.05), but at T2 and T4 time points, the levels of HR and MAP in the experimental group were lower than those in the control group (P<0.05). At T1 time point, there were no significant differences in the levels of cortisol (Cor), noradrenaline (NE) and epinephrine (E) between the two groups (P>0.05). At T2, T3 and T4 time point, the levels of Cor, NE and E in the experimental group were lower than those in the control group (P<0.05).

Conclusion

The application of sevoflurane inhalation anesthesia in elderly patients undergoing tension-free hernia repair not only has good anesthesia effect, but also can increase the stability of cardiovascular system and inhibit stress reaction, which is worthy for clinical promoting.

Key words: Herniorrhaphy, Sevoflurane, Remifentanil, Anesthesia, Stress index, Hemodynamics

Zhan Wang. Effects of sevoflurane inhalation anesthesia and remifentanil intravenous anesthesia on stress in elderly patients undergoing tension-free hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(06): 549-552.

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References 20

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时间	组别	例数	HR(次/min)	MAP(mmHg)	SPO₂(%)
T1	对照组	33	77.35±6.41	65.32±7.13	97.34±0.62
	试验组	33	78.23±7.11	66.23±7.05	97.13±0.67
	F值	?	0.279	0.272	1.746
	P值	?	0.599	0.604	0.191
T2	对照组	33	97.15±6.53	74.31±8.39	95.11±0.37
	试验组	33	86.95±5.01	69.49±7.34	95.15±0.35
	F值	?	50.683	6.169	0.451
	P值	?	<0.001	0.016	0.653
T3	对照组	33	79.22±7.86	66.32±6.15	97.33±0.27
	试验组	33	78.53±8.11	65.11±7.81	97.23±0.38
	F值	?	0.123	0.489	1.519
	P值	?	0.727	0.487	0.222
T4	对照组	33	103.24±7.31	76.15±7.22	95.37±0.19
	试验组	33	90.16±6.77	70.16±7.61	95.30±0.24
	F值	?	56.527	10.760	1.726
	P值	?	<0.001	0.002	0.194

时间	组别	例数	HR(次/min)	MAP(mmHg)	SPO₂(%)
T1	对照组	33	77.35±6.41	65.32±7.13	97.34±0.62
	试验组	33	78.23±7.11	66.23±7.05	97.13±0.67
	F值	?	0.279	0.272	1.746
	P值	?	0.599	0.604	0.191
T2	对照组	33	97.15±6.53	74.31±8.39	95.11±0.37
	试验组	33	86.95±5.01	69.49±7.34	95.15±0.35
	F值	?	50.683	6.169	0.451
	P值	?	<0.001	0.016	0.653
T3	对照组	33	79.22±7.86	66.32±6.15	97.33±0.27
	试验组	33	78.53±8.11	65.11±7.81	97.23±0.38
	F值	?	0.123	0.489	1.519
	P值	?	0.727	0.487	0.222
T4	对照组	33	103.24±7.31	76.15±7.22	95.37±0.19
	试验组	33	90.16±6.77	70.16±7.61	95.30±0.24
	F值	?	56.527	10.760	1.726
	P值	?	<0.001	0.002	0.194

组别	例数	诱导时间(s)	苏醒时间(min)
对照组	33	71.74±9.34	16.34±5.22
试验组	33	67.24±7.03	13.53±4.57
t值	?	2.211	2.327
P值	?	0.031	0.023

组别	例数	诱导时间(s)	苏醒时间(min)
对照组	33	71.74±9.34	16.34±5.22
试验组	33	67.24±7.03	13.53±4.57
t值	?	2.211	2.327
P值	?	0.031	0.023

时间	组别	例数	Cor(pg/ml)	NE(ng/ml)	E(ng/ml)
T1	对照组	33	405.45±47.34	64.34±7.77	74.55±7.45
	试验组	33	402.34±50.55	65.09±6.98	74.15±8.03
	F值	?	0.067	0.170	0.044
	P值	?	0.797	0.681	0.835
T2	对照组	33	510.87±60.44	79.65±8.04	96.45±9.03
	试验组	33	433.34±50.78	70.27±6.26	79.88±8.81
	F值	?	31.831	27.964	56.929
	P值	?	0.000	<0.001	<0.001
T3	对照组	33	457.98±39.56	72.22±7.25	80.63±9.41
	试验组	33	422.07±40.62	64.68±5.55	75.32±7.77
	F值	?	13.236	22.505	6.248
	P值	?	0.001	<0.001	0.015
T4	对照组	33	535.34±66.42	82.46±7.73	103.87±10.35
	试验组	33	479.46±53.67	70.69±8.45	90.24±8.47
	F值	?	14.131	34.856	34.276
	P值	?	<0.001	<0.001	<0.001

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