ABSTRACT
Objective:To investigate the anesthetic effects of inhalational sevoflurane versus intravenous ketamine in pediatric surgical anesthesia. Methods:A total of 100 patients with appendicitis who underwent appendectomy in Ningbo Ninth Hospital between June 2017 and August 2018 were included in this study. They were randomly assigned to receive either inhalational anesthesia with sevoflurane (observation group, n = 50) or intravenous anesthesia with ketamine (control group, n = 50). Hemodynamic indexes at different time periods (T1: 5 minutes after entering the room, T2: after anesthesia induction, T3: immediately after skin incision, T4: operation completion), anesthesia induction, duration for anesthesia induction and recovery from anesthesia, liver function, and adverse reactions were compared between the observation and control groups. Results:There was no significant difference in peripheral oxygen saturation (SpO 2) level at different time periods between the observation and control groups (all P > 0.05). At T1, there were no significant differences in mean arterial pressure and heart rate between the two groups (both P > 0.05). At T2, T3 and T4, mean arterial pressure in the observation group was (67.25 ± 1.32) mmHg, (67.52 ± 1.32) mmHg, and (66.28 ± 1.31) mmHg, respectively, and heart rate was (115.21 ± 2.32) beats/minute, (112.21 ± 1.34) beats/minute and (111.25 ± 1.32) beats/minute, respectively. There were significant differences in mean arterial pressure and heart rate measured at T2, T3 and T4 between the observation and control groups ( t = 19.176, 16.817, 30.015, 58.797, 51.649, 2.617, all P < 0.05). The time to pain reflex disappearance and the time to eyelash reflex disappearance in the observation group were (2.32 ± 0.21) minutes and (1.26 ± 0.32) minutes, respectively, which were significantly longer than those in the control group ( t = 9.247, 4.251, both P < 0.05). The time to eye opening or body movement and the time to getting out of operation room were (3.21 ± 1.32) minutes and (5.52 ± 1.13) minutes respectively, which were significantly shorter than those in the control group ( t = 91.851, 109.641, both P < 0.05). After surgery, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and bilirubin levels in the observation group were (26.01 ± 1.32) U/L, (22.02 ± 1.32) U/L, (486.32 ± 2.74) U/L, (0.66 ± 0.02) U/L, respectively. There were significant differences in these indexes between observation and control groups ( t = 6.036, 6.798, 23.741, 3.500, all P < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group ( χ2 = 9.470, P < 0.05). Conclusion:Inhalational sevoflurane is advantageous over and safer than intravenous ketamine in pediatric surgical anesthesia.