To explore the prevention and control effect of oxycodone on emergence agitation in patients undergoing laparoscopic hernia repair by optimizing analgesia and stress regulation.

This was a retrospective controlled study. A retrospective analysis was conducted on the medical records of 284 patients with inguinal hernia who underwent laparoscopic hernia repair surgery at Chuiyangliu Hospital affiliated with Tsinghua University from January 2023 to October 2025, the patients were divided into an experimental group and a control group, with 142 patients in each group, according to different anesthesia methods. The control group was given conventional anesthesia, while the experimental group was combined with oxycodone anesthesia on the basis of the control group. The perioperative conditions, Visual Analogue Scale (VAS) scores, serum cortisol, norepinephrine (NE), epinephrine levels, recovery conditions, and the incidence of adverse reactions were compared.

The extubation time and recovery time in the experimental group were both shorter than those in the control group (P<0.05, both effect sizes were 0.35). The VAS scores in the experimental group at 4, 8, 12 and 24 hours after the operation were lower than those in control group (P<0.05, effect size range: 0.24 to 0.41). Immediately after the operation, the levels of serum cortisol, NE, and epinephrine in the experimental group were lower (P<0.05, effect size range: 0.32 to 0.40). The Richmond Restlessness and Sedation Scale (RASS) scores in the experimental group at the moment of extubation and 10 minutes and 30 minutes after extubation were all lower than those in the control group, and the incidence of emergence agitation was lower (P<0.05, effect size range: 0.25 to 0.38). Comparison of the incidence of excessive sedation and adverse reactions between the two groups, with no statistically significant difference (P>0.05, both effect sizes were 0.024).

Oxycodone can enhance the analgesic effect after laparoscopic hernia repair, alleviate stress responses, and reduce the incidence of emergence agitation.