To explore the effects of remifentanil combined with propofol for total intravenous anesthesia on the hemodynamic status and anesthesia recovery quality of children undergoing laparoscopic high ligation of hernial sac for indirect inguinal hernia.

This was a prospective randomized controlled trial. A total of 100 children who underwent laparoscopic high ligation of hernial sac for indirect inguinal hernia in Fuyang Women and Children's Hospital from January 2022 to December 2023 were enrolled as the research subjects. They were divided into the control group (receiving fentanyl combined with propofol anesthesia, n=50) and the trial group (receiving remifentanil combined with propofol anesthesia, n=50) according to the random number table method. The hemodynamic parameters [heart rate, mean arterial pressure (MAP)] and stress response indicators [adrenaline, cortisol] before anesthesia induction (T₁), after tracheal intubation (T₂), at the end of the surgery (T₃), and at the time of tracheal extubation (T₄) were compared between the two groups. The postoperative awakening time and extubation time of the children in both groups were recorded, and the postoperative adverse reactions were statistically analyzed.

The heart rate, MAP, adrenaline and cortisol levels of the trial group at time-points T2, T3 and T4 were significantly lower than those of the control group (P<0.05, the between-group effect sizes (partial η²) of repeated measures variance analysis were 0.150, 0.121, 0.094, and 0.086, respectively). The recovery time and extubation time of the trial group were both shorter than those of the control group, and the incidence of adverse reactions was lower than that of the control group (P<0.05).

Remifentanil combined with propofol for total intravenous anesthesia in pediatric laparoscopic high ligation of hernial sac for indirect inguinal hernia can stabilize hemodynamics, reduce stress responses, and minimize adverse reactions, thereby enhancing anesthesia safety and postoperative recovery quality.