Comparison of the effects of two anesthetic methods on laparoscopic surgery in children

Abstract

Objective To compare the effects of two anesthetic schemes on pediatric laparoscopic surgery, and the influence on stress response and hemodynamics. Methods From November 2016 to November 2017, 100 children underwent laparoscopic surgery in the Affiliated Hospital of Medical College of Ningbo University were selected and divided into two groups by odd even number of beds, with 50 cases in each group.The control group was treated with general anesthesia.The observation group received total intravenous anesthesia with remifentanil and propofol.The anesthesia effect, stress response and hemodynamic indexes were compared between the two groups. Results The postoperative waking time[(31.48 ±4.19)min], the time of disappearance of mascara reflex[(2.32±1.62)min], the recovery time of spontaneous respiration [(1.96±1.45)min], the incidence of adverse reactions[4.00%(2/50)], Ramsay score[(3.69±0.43)points], VAS score[(1.96±1.42)points], immediate Ramsay score[(2.11±0.82)points] and immediate VAS score[(2.31±0.43)points] in the observation group were better than those in the control group (t=15.623, 1.436, 5.436, χ2=5.432, t=1.187, 1.528, 2.136, 2.431, all P<0.05). At different time points, the MAP, HR and stress response(cortisol, blood glucose, PaO2, MAP) in the observation group were better than those in the control group(all P<0.05). Conclusion General anesthesia has higher risk in children undergoing laparoscopic surgery and can prolong the time of conscious consciousness.Remifentanil combined with propofol, total intravenous anesthesia can stabilize hemodynamics, improve the safety of anesthesia and alleviate stress reaction in children undergoing laparoscopic surgery. Key words: Anesthesis, general; Anesthesis, intravenous; Laparoscopes; Stress response; Hemodynamics; Efficacy; Safety; Child