Comparison of application of sevoflurane inhalation anesthesia and propofol intravenous anesthesia in pediatric indirect inguinal hernia surgery

doi:10.3877/cma.j.issn.1674-392X.2024.05.019

Abstract

Abstract:

Objective

To compare the application effect of sevoflurane inhalation anesthesia and propofol intravenous anesthesia in pediatric indirect inguinal hernia surgery.

Methods

92 children with indirect inguinal hernia who underwent laparoscopic high ligation of hernia sac at Hai'an People's Hospital from January 2019 to January 2022 were selected as the study subjects. They were divided into the observation group (using sevoflurane inhalation anesthesia) and the control group (using propofol intravenous anesthesia) by means of the random number table method, with 46 cases in each group. The hemodynamic indexes before anesthesia (T0), at skin incision (T1), after skin incision (T2) and at the end of surgery (T3), stress response indexes at 20 min before surgery and at 2 h after surgery, anesthesia quality, pain status at 2 h and 24 h after surgery, occurrence of restlessness within 1 h after surgery and incidence of complications in the two groups of children were analyzed by statistical method.

Results

At T1 and T2, the mean arterial pressure (MAP) and heart rate of children in the observation group were higher than those in the control group (P＜0.05). After surgery, the levels of renin, epinephrine and norepinephrine in the observation group were lower than those in the control group (P＜0.05). The time of opening eyes, waking up and recovery of orientation in the observation group were shorter than those in the control group (P＜0.05). The pain scores in the observation group at 2 h and 24 h after surgery were significantly lower compared with those in the control group (P＜0.05). The incidence of restlessness and total incidence of adverse reactions in the observation group were lower than those in the control group, but there was no significant difference (P＞0.05).

Conclusion

Sevoflurane inhalation anesthesia for children undergoing laparoscopic high ligation of the hernia sac can improve the hemodynamics and anesthesia quality, reduce the stress response.

Key words: Indirect inguinal hernia, Herniorrhaphy, Children, Sevoflurane, Inhalation anesthesia, Hemodynamics, Stress response, Incidence of restlessness

Hebei Ding, Xun Wang, Weiguo Chen. Comparison of application of sevoflurane inhalation anesthesia and propofol intravenous anesthesia in pediatric indirect inguinal hernia surgery[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2024, 18(05): 570-574.

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Figures/Tables 5

组别	例数	年龄(岁, $\overset{ˉ}{x}$ ±s)	性别[例(%)]		类型[例(%)]		体重(kg, $\overset{ˉ}{x}$ ±s)	手术时间(min, $\overset{ˉ}{x}$ ±s)	麻醉时间(min, $\overset{ˉ}{x}$ ±s)
组别	例数	年龄(岁, $\overset{ˉ}{x}$ ±s)	男性	女性	易复性	难复性	体重(kg, $\overset{ˉ}{x}$ ±s)	手术时间(min, $\overset{ˉ}{x}$ ±s)	麻醉时间(min, $\overset{ˉ}{x}$ ±s)
观察组	46	1.75±0.56	43(93.48)	3(6.52)	31(67.39)	15(32.61)	18.31±1.32	22.47±3.56	25.43±4.45
对照组	46	1.87±0.59	44(95.65)	2(4.35)	34(73.91)	12(26.09)	18.28±1.54	23.28±3.67	26.54±4.68
t/χ²值		1.001	0.000		0.472		0.100	1.074	1.166
P值		0.320	1.000		0.492		0.920	0.286	0.247

组别	例数	年龄(岁, $\overset{ˉ}{x}$ ±s)	性别[例(%)]		类型[例(%)]		体重(kg, $\overset{ˉ}{x}$ ±s)	手术时间(min, $\overset{ˉ}{x}$ ±s)	麻醉时间(min, $\overset{ˉ}{x}$ ±s)
组别	例数	年龄(岁, $\overset{ˉ}{x}$ ±s)	男性	女性	易复性	难复性	体重(kg, $\overset{ˉ}{x}$ ±s)	手术时间(min, $\overset{ˉ}{x}$ ±s)	麻醉时间(min, $\overset{ˉ}{x}$ ±s)
观察组	46	1.75±0.56	43(93.48)	3(6.52)	31(67.39)	15(32.61)	18.31±1.32	22.47±3.56	25.43±4.45
对照组	46	1.87±0.59	44(95.65)	2(4.35)	34(73.91)	12(26.09)	18.28±1.54	23.28±3.67	26.54±4.68
t/χ²值		1.001	0.000		0.472		0.100	1.074	1.166
P值		0.320	1.000		0.492		0.920	0.286	0.247

组别	例数	平均动脉压(mmHg)				心率(次/min)
组别	例数	T₀	T₁	T₂	T₃	T₀	T₁	T₂	T₃
观察组	46	91.23±7.28	76.25±5.35^①	81.65±5.21^①	87.21±6.87	100.21±4.87	96.32±3.76^①	89.76±5.09^①	103.43±6.32
对照组	46	90.41±7.32	70.57±4.36^①	75.24±4.21^①	89.43±5.43	100.65±4.64	91.24±3.65^①	85.64±3.54^①	103.53±6.43
F值		F _组间=19.060,F_时间=179.600,F_交互=11.210				F _组间=17.930,F_时间=189.800,F_交互=7.724
P值		P _组间＜0.001,P_时间＜0.001,P_交互＜0.001				P _组间＜0.001,P_时间＜0.001,P_交互＜0.001

组别	例数	肾素[ng/(ml·h)]			肾上腺素(pmol/L)			去甲肾上腺素(pg/ml)
组别	例数	术前	术后	差值	术前	术后	差值	术前	术后	差值
观察组	46	1.97±0.34	2.44±0.53^②	-0.47±0.09	377.56±112.31	500.43±121.54^②	-122.87±24.40	365.32±110.63	528.24±109.43^②	-162.92±22.94
对照组	46	2.02±0.37	3.23±0.32^②	-1.21±0.07	371.54±103.32	581.54±127.57^②	-210.00±24.20	366.34±111.23	594.78±141.54^②	-228.44±26.54
t值		0.674	8.654	44.019	0.268	3.122	17.196	0.044	2.522	12.668
P值		0.502	＜0.001	＜0.001	0.790	0.002	＜0.001	0.965	0.013	＜0.001

组别	例数	睁眼时间	清醒时间	定向力恢复时间
观察组	46	11.42±2.12	18.23±4.21	20.48±3.21
对照组	46	14.32±3.45	22.37±5.65	23.43±4.55
t值		4.857	3.985	3.593
P值		＜0.001	0.001	0.001

组别	例数	躁动发生[例(%)]	疼痛视觉模拟评分( $\overset{ˉ}{x}$ ±s)
组别	例数	躁动发生[例(%)]	术后2h	术后24h
观察组	46	1(2.17)	4.32±0.76	3.12±0.79^a
对照组	46	3(6.52)	4.69±0.81	3.80±0.92^a
χ ² /t值		0.261	2.259	3.803
P值		0.609	0.026	＜0.001

组别	例数	躁动发生[例(%)]	疼痛视觉模拟评分( $\overset{ˉ}{x}$ ±s)
组别	例数	躁动发生[例(%)]	术后2h	术后24h
观察组	46	1(2.17)	4.32±0.76	3.12±0.79^a
对照组	46	3(6.52)	4.69±0.81	3.80±0.92^a
χ ² /t值		0.261	2.259	3.803
P值		0.609	0.026	＜0.001

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