Abstract:
Objective To investigate the anesthetic effects of remifentanil and propofol combined with sevoflurane in laparoscopic inguinal hernia surgery in children.
Methods A total of 60 cases of children undergoing laparoscopic oblique surgery of the groin and thigh in our hospital from June 2020 to June 2021 were selected as the research objects. All the children were randomly divided into two groups according to the number method, remifentanil combined with sevoflurane for the remifentanil group (30 cases) and propofol combined with sevoflurane in propofol group (30 cases). The extubation time, recovery time, directional recovery time, mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2) and other stress indicators were recorded in the two groups before anesthesia (T0), after induction (T1), pneumoperitoneum 5 min (T2), and after extubation (T3). Postoperative agitation score (PAED) and pain score (FLACC), and the incidence of postoperative adverse reactions were also recorded.
Results The extubation time, awakening time and directional recovery time in the remifentanil group were shorter than those in the propofol group (P<0.05). Compared with T0, MAP, HR and SpO2 of T2 and T3 in the two children's groups were gradually decreased (P<0.05). At the same stage, MAP and HR fluctuations of T1, T2 and T3 in the remifentanil group were lower than those in the propofol group (P<0.05), and SpO2 was higher than that in the propofol group (P<0.05). The PAED score of the remifentanil group was lower than that of the propofol group (P<0.05). The pain scores of the two groups were significantly lower at 6 h (t2) and 12 h (t3) than at t0 (P<0.05). The FLACC score of t0-t3 in the remifentanil group was lower than that in the propofol group (P<0.05). The total adverse reactions in the remifentanil group were lower than those in the propofol group (P<0.05).
Conclusion In laparoscopic indirect femoral sulcus hernia in children, the anesthetic effect and hemodynamics of sevoflurane combined with remifentanil were better than those of the propofol group. This shortened the time it took for children to recover from surgery, reduced postoperative pain and agitation, and lessened the effects of side effects like respiratory depression.
Key words:
Remifentanil,
Propofol,
Sevoflurane,
Oblique inguinal hernia,
Laparoscope,
Child
Meiping Ding, Yiyong Bao, Youqin Wei, Ding Wu, Zhidong Wu. Anesthetic effect of remifentanil and propofol combined with sevoflurane in laparoscopic inguinal hernia surgery in children[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(04): 435-438.