七氟烷吸入麻醉与异丙酚静脉麻醉在儿童腹股沟斜疝手术中的应用比较

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

目的比较七氟烷吸入麻醉与异丙酚静脉麻醉在儿童腹股沟斜疝手术中的应用效果。方法选取2019年1月至2022年1月,于海安市人民医院行腹腔镜疝囊高位结扎术的腹股沟斜疝患儿92例为研究对象,按照随机数字表法分为观察组(采用七氟烷吸入麻醉)和对照组(采用异丙酚静脉麻醉),各46例。采用统计学方法分析2组患儿麻醉前(T0)、切皮时(T1)、切皮后(T2)以及手术结束时(T3)血流动力学指标,术前20 min、术后2 h应激反应指标、麻醉质量,术后2 h及24 h疼痛情况,术后1 h内躁动发生情况,并发症发生率。结果与对照组比较,在T1、T2时刻,观察组患儿的平均动脉压(MAP)更高、心率更快;术后肾素、肾上腺素、去甲肾上腺素值更低(P<0.05);睁眼时间、清醒时间、定向力恢复时间更短;术后2、24 h疼痛评分更低(P<0.05),差异均有统计学意义(P<0.05)。观察组患儿躁动发生率、不良反应总发生率低于对照组患儿,但差异无统计学意义(P>0.05)。结论腹腔镜疝囊高位结扎术患儿采用七氟烷吸入麻醉能够改善其血流动力学情况及麻醉质量,降低应激反应风险。

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&apos;an People&apos;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.