To explore the effect of nalbuphine combined with remifentanil after laparoscopic totally extra-peritoneal inguinal hernia repair (TEP) surgery.

A prospective study was conducted on 88 patients with inguinal hernia who were admitted to Yancheng Third People's Hospital for surgical treatment from January 2020 to June 2022. All patients were divided into control group (n=44) and observation group (n=44) according to random number table method. All patients in the two groups underwent TEP after tracheal intubation general anesthesia. The observation group was given nalbuphine 5 minutes before the end of operation. The control group was given the same amount of normal saline. The mean arterial pressure, heart rate and blood oxygen saturation at the time of operation completion, extubation and 0.5h after operation were compared between the two groups. The analgesic effects of the two groups at 0.5, 2, 6, and 12 h after operation were compared using visual analog score (VAS). The adverse reactions induced by anesthetic drugs in the two groups were compared. The serum stress response indexes [adrenaline, noradrenaline (NE), cortisol], serum inflammatory response indexes [interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α)] of the two groups were compared 0.5 h before and 4 h after surgery.

There was no significant difference in mean arterial pressure, heart rate and blood oxygen saturation between the two groups at the time of operation completion, extubation and 0.5h after operation (P>0.05). The VAS scores in the observation group at 2, 6, and 12 h after operation were lower than those in the control group (P<0.05). There was no significant difference between the two groups in VAS score 0.5 h after operation (P>0.05). There was no adverse reaction induced by anesthetic drugs in both groups. There was no significant difference in adrenaline, NE, cortisol, IL-6, CRP, TNF-α between the two groups at 0.5 h before operation (P>0.05). Adrenaline, NE, cortisol, IL-6, CRP, TNF-α increased in both groups at 4 h after operation, and those in the observation group were lower than those in the control group (P<0.05).

In inguinal hernia patients with TEP surgery under tracheal intubation general anesthesia , the use of nalbuphine can reduce the degree of postoperative pain, stress reaction and inflammatory reaction intensity, without increasing the risk of adverse drug reactions.