Application of remifentanil combined with propofol intravenous anesthesia in children undergoing laparoscopic surgery for oblique inguinal hernia and its effect on hemodynamics
10.3760/cma.j.cn431274-20240325-00496
- VernacularTitle:瑞芬太尼联合丙泊酚静脉麻醉在腹腔镜下腹股沟斜疝手术患儿麻醉中的应用及对血流动力学的影响
- Author:
Liang ZHANG
1
;
Zhigang SHANG
1
Author Information
1. 乌鲁木齐市第一人民医院麻醉科，乌鲁木齐 830002
- Publication Type:Journal Article
- Keywords:
Hernia, inguinal;
Laparoscopy;
Remifentanil;
Propofol;
Hemodynamics
- From:
Journal of Chinese Physician
2025;27(1):47-51
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of remifentanil and fentanyl combined with propofol intravenous anesthesia on hemodynamics and quality of anesthesia recovery in children undergoing laparoscopic surgery for oblique inguinal hernia.Methods:A total of 98 children with oblique inguinal hernia admitted to the Urumqi First People′s Hospital from January 2022 to January 2023 were selected as the study objects, and randomly divided into control group and observation group with 49 cases in each group according to the 1∶1 ratio number list method. The control group received fentanyl+ propofol anesthesia, and the observation group received remifentanil+ propofol anesthesia. The hemodynamics, quality of anesthesia recovery, stress response indexes and adverse reactions were compared at different time points between the two groups.Results:The recovery time and extubation time of the observation group were shorter than those of the control group ( P<0.05). There was no significant difference in Steward and 15-item Recovery Quality Scale (QoR-15) scores between the two groups (all P>0.05). The scores of Steward, QoR-15 and revised Wang Baker Facial Expression Pain Assessment Scale (FPSR) in both groups were higher than those in the recovery room and 24 h after surgery, and the scores of Steward and QoR-15 in the observation group were higher than those in the control group at the recovery room and 24 h after surgery ( P<0.05). The FPSR scores of the observation group were lower than those of the control group at the time of recovery, exit from the recovery room and 24 h after operation (all P<0.05). There was no significant difference in mean arterial pressure and heart rate between the two groups at T 1 ( P>0.05). Compared with T 1, the mean arterial pressure and heart rate of T 2, T 3 and T 4 in both groups showed significant fluctuations (all P<0.05). Compared with the control group, the mean arterial pressure and heart rate of T 2, T 3 and T 4 in the observation group were significantly smaller (all P<0.05). There was no significant difference in T 1 stress response between the two groups (all P>0.05). The levels of epinephrine (E), C-reactive protein (CRP) and cortisol (Cor) in serum at T 2, T 3 and T 4 were higher than those at T 1 (all P<0.05). The levels of E, CRP and Cor in serum at T 2, T 3 and T 4 in the observation group were significantly lower than those in the control group (all P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant (χ 2=4.159, P<0.05). Conclusions:Intravenous anesthesia with remifentanil combined with propofol can reduce the effect on hemodynamics, improve the quality of anesthesia recovery and alleviate the stress response of the body in children with laparoscopic oblique inguinal hernia.
