对比七氟烷与异丙酚对腹腔镜疝囊高位结扎手术患儿认知、应激及疼痛的影响

目的对比七氟烷与异丙酚对腹股沟疝手术患儿认知、应激及疼痛的影响。 方法选取2017年9月至2018年11月重庆市永川区儿童医院90例腹股沟疝患儿，通过随机数字表法分为观察组、对照组，各45例。对照组采用异丙酚静脉麻醉，而观察组采用七氟烷吸入麻醉。比较2组患者的麻醉效果指标，术后1 h、术后1 d以及术后2 d疼痛情况，麻醉诱导前及切皮时应激反应指标，麻醉前、应答后2、4、6、24 h认知功能。 结果观察组麻醉起效时间、呼吸恢复时间短于对照组（P<0.05）。术后1 h、术后1 d及2 d2组的儿童疼痛评分（CHEOPS）随时间延长均下降（P<0.05），但2组各时间点均无统计学差异（P>0.05）。切皮时与麻醉诱导前比较，2组血清皮质醇（Cor）、去甲肾上腺素（NE）及肾上腺素（E）水平均升高，但观察组均低于对照组（P<0.05）。应答后2、4、6、24 h 2组简易精神状况检查评分（MMSE）随时间变化呈上升趋势（P<0.05）。应答后2、4 h2组MMSE评分低于麻醉前，对照组低于观察组（P<0.05）。 结论相较异丙酚，七氟烷对腹股沟疝手术患儿麻醉效果更佳，可改善其认知功能，抑制机体应激及疼痛。

Comparison of the effects of sevoflurane and propofol on cognition,stress and pain in children with laparoscopic inguinal hernia sac high ligation procedure

ObjectiveTo compare the effects of sevoflurane and propofol on cognition, stress and pain in children with inguinal hernia surgery. MethodsBetween September 2017 and November 2018, 90 cases of inguinal hernia in Chongqing Yongchuan children's hospital were divided into the observation group and the control group by random number table method, with 45 cases in each group. The control group received propofol intravenous anesthesia, while the test group received sevoflurane inhaled anesthesia. Comparison of anesthesia effect indicators, pain at 1 hour, 1 day after surgery, and 2 days after surgery, stress response indicators before anesthesia induction and skin incision, cognitive function before anesthesia, at 2, 4, 6 and 24 hours after response. ResultsThe anesthesia onset time and respiratory recovery time of the observation group were lower than those of the control group (P<0.05). The CHEOPS scores of the two groups decreased with time at 1 h, 1 and 2 days after surgery (P<0.05), but there was no statistical difference between the two groups at each time point (P>0.05). Compared with those before induction of anesthesia, the levels of serum NE, E, and Cor in the two groups were increased, but those in the observation group were lower than those in the control group (P<0.05). The MMSE scores of the two groups of patients at 2, 4, 6, and 24 hours after the response showed an increasing trend with time (P<0.05). The MMSE scores of the two groups at 2 and 4 hours after the response were lower than that before anesthesia, and the control group was lower than the observation group (P<0.05). ConclusionCompared with propofol, sevoflurane has better anesthesia effect on children with inguinal hernia surgery, it can improve its cognitive function, and suppress body stress and pain.