Abstract:

Objective

To study the effect of general anesthesia with S(+)-ketamine and sufentanil on intraoperative hemodynamics and postoperative spontaneous recovery in children undergoing laparoscopic high ligation of hernia sac.

Methods

A total of 88 children who underwent laparoscopic high ligation of hernia sac in Linquan County People's Hospital from February 2022 to May 2023 were selected and divided into observation group and control group with 44 cases in each group by the random number table method.Both groups underwent laparoscopic high ligation of hernia sac under intravenous-inhalation general anesthesia.The anesthesia induction regimen in the observation group was cis-atracurium (0.05 mg/kg),propofol (3 mg/kg), S(+)-ketamine (0.5 mg/kg) and anisodamine (0.1 mg/kg) intravenous drip, while the control group was changed from S(+)-ketamine to sufentanil (0.2 μg/kg) intravenous drip, and sevoflurane was used to maintain anesthesia in both groups.Perioperative indicators, hemodynamics, the Chinese version face, legs, activity, cry, consolability behavioral tool scale score, postoperative recovery quality and adverse reactions were compared between the two groups.

Results

The heart rate (HR) immediately after tracheal intubation (T2) was significantly increased in both groups (P<0.05), and the mean arterial pressure (MAP)from T2 to immediately after the end of surgery (T5) was significantly increased (P<0.05).HR at T2 in observation group was lower than that in control group, and MAP at T2-T5 was lower than that in control group, the difference was statistically significant (P<0.05).The proportion of remedial analgesia at 24 hours after surgery was lower in observation group than that in control group, the difference was statistically significant (P<0.05).The postoperative spontaneous breathing recovery time, anesthesia recovery time and incidence rate of recovery agitation in observation group were lower compared with those in control group,the differences were statistically significant (P<0.05).There were no statistically significant differences in the incidence rates of adverse reactions such as bradycardia, hypotension and nausea and vomiting between the two groups (P>0.05).

Conclusion

The application of S(+)-ketamine for general anesthesia in children undergoing laparoscopic high ligation of hernia sac is beneficial to maintaining perioperative hemodynamic stability, enhancing postoperative analgesia effect, shortening anesthesia recovery time and reducing the risk of recovery agitation.

Key words: Laparoscopic high ligation of hernia sac, Children, General anesthesia, Hemodynamics, Adverse reactions, S(+)-ketamine, Sufentanil