Effects of intravenous anesthesia of ketamine combined with caudal block of ropivacaine on stress response in children with inguinal hernia

doi:10.3877/cma.j.issn.1674-392X.2019.03.009

Abstract

Abstract:

Objective

To explore the effects of intravenous anesthesia of ketamine combined with caudal block of ropivacaine on stress response in children with inguinal hernia.

Methods

82 cases of inguinal hernia in Baoding Children's hospital from November 2015 to December 2017 were randomly divided into control group and study group. The control group received intravenous anesthesia of ketamine, and the study group received intravenous anesthesia of ketamine combined with caudal block of ropivacaine. The levels of stress response index [cortisol, interleukin-6 (IL-6)] before anesthesia (T1), 10 min after anesthesia (T2), immediately after operation (T3), and 8 hours after operation (T4), dose of ketamine, time of awakening, scores of pain (FLACC) and restlessness during the awakening period (AS) 5, 60 and 120 minutes after operation and the incidence of adverse reactions of two groups were compared.

Results

The levels of serum cortisol and IL-6 in T1 in the two groups were higher than those in T2, but the study group was lower than the control group (P<0.05). The levels of serum cortisol and IL-6 in T3 and 4 in the two groups were lower than those in T2, and the study group was lower than the control group (P<0.05). The dosage of ketamine in the study group was less than that in the control group, and the time of awakening was shorter than that in the control group (P<0.05). The scores of FLACC and AS in the study group were lower than those in the control group at 5, 60, and 120 minutes after operation (P<0.05). The incidence of vomiting (7.32%), restlessness (12.20%) and lethargy (9.76%) in the study group were lower than those in the control group (P<0.05).

Conclusion

Intravenous anesthesia of ketamine combined with caudal block of ropivacaine in the operation of children with inguinal hernia can reduce the dosage of ketamine, shorten the time of awakening, reduce the degree of stress reaction during the operation, and reduce the postoperative pain and restlessness. Besides, it can reduce the incidence of adverse reactions.

Key words: Hernia, inguinal, Ketamine, Intravenous anesthesia, Ropivacaine, Stress response

Guang Liu, Huise Wang. Effects of intravenous anesthesia of ketamine combined with caudal block of ropivacaine on stress response in children with inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(03): 226-230.

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References 21

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一般资料	试验组(41例)	对照组(41例)	统计值	P值
年龄(岁, ±s)	(4.59±2.04)	(4.81±1.96)	0.498	0.620
性别[例(%)]			0.000	1.000
男	38(92.68)	39(95.12)
女	3(7.32)	2(4.88)
病程(个月, ±s)	(2.78±1.03)	(2.85±0.99)	0.314	0.755
体质量(kg, ±s)	(19.03±4.15)	(18.92±4.03)	0.122	0.903
美国麻醉医师协会分级[例(%)]
Ⅰ级	16(39.02)	18(43.90)	0.201	0.654
Ⅱ级	25(60.98)	23(56.10)	0.201	0.654

一般资料	试验组(41例)	对照组(41例)	统计值	P值
年龄(岁, ±s)	(4.59±2.04)	(4.81±1.96)	0.498	0.620
性别[例(%)]			0.000	1.000
男	38(92.68)	39(95.12)
女	3(7.32)	2(4.88)
病程(个月, ±s)	(2.78±1.03)	(2.85±0.99)	0.314	0.755
体质量(kg, ±s)	(19.03±4.15)	(18.92±4.03)	0.122	0.903
美国麻醉医师协会分级[例(%)]
Ⅰ级	16(39.02)	18(43.90)	0.201	0.654
Ⅱ级	25(60.98)	23(56.10)	0.201	0.654

组别	项目	例数	麻醉前	麻醉后10 min	术后即刻	术后8 h
试验组	皮质醇(mmol/L)	41	12.28±2.71	15.62±3.01	14.86±2.51	13.04±2.96
对照组		41	12.04±2.58	24.33±4.51	20.53±3.37	17.15±3.11
t值			0.411	10.286	8.640	6.130
P值			0.682	0.000	0.000	0.000
试验组	白细胞介素6(pg/L)	41	4.11±1.41	6.08±1.20	5.81±1.07	4.38±1.39
对照组		41	4.20±1.37	14.57±2.62	11.18±2.05	7.11±2.22
t值			0.293	18.865	14.869	6.674
P值			0.770	<0.001	<0.001	<0.001

组别	项目	例数	麻醉前	麻醉后10 min	术后即刻	术后8 h
试验组	皮质醇(mmol/L)	41	12.28±2.71	15.62±3.01	14.86±2.51	13.04±2.96
对照组		41	12.04±2.58	24.33±4.51	20.53±3.37	17.15±3.11
t值			0.411	10.286	8.640	6.130
P值			0.682	0.000	0.000	0.000
试验组	白细胞介素6(pg/L)	41	4.11±1.41	6.08±1.20	5.81±1.07	4.38±1.39
对照组		41	4.20±1.37	14.57±2.62	11.18±2.05	7.11±2.22
t值			0.293	18.865	14.869	6.674
P值			0.770	<0.001	<0.001	<0.001

组别	例数	氯胺酮用量(mg)	苏醒时间(min)
试验组	41	31.04±7.12	22.41±4.62
对照组	41	47.28±10.33	36.87±5.91
t值		8.288	12.343
P值		<0.001	<0.001

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