Effects of dexmedetomidine on hemodynamics, quality of recovery from anesthesia and postoperative analgesia in children patients with hernia subjected to laparoscopic hernia repair / 中国基层医药

ABSTRACT

Objective:To investigate the effects of dexmedetomidine on hemodynamics, quality of recovery from anesthesia and postoperative analgesia in children patients with hernia subjected to laparoscopic hernia repair.Methods:A total of 120 children patients who received laparoscopic hernia repair in Shangyu Maternal and Child Health Hospital from March 2019 to March 2020 were included in this study. They were randomly assigned to receive anesthesia maintenance with either inhaled sevoflurane (control group, n = 60) or intravenous dexmedetomidine hydrochloride (observation group, n = 60). The hemodynamic changes at different time points [5 minutes before skin incision (T0), 5 minutes after skin incision (T1) and 15 minutes after skin incision (T2)] were compared between the control and observation groups. Time to extubation, time to recovery from anesthesia, time to wake up, occurrence of agitation, and duration of agitation were compared between the two groups. Visual Analogue Scale score at 3, 12 and 24 hours after surgery were compared between the control and observation groups. Results:Mean arterial pressure and heart rate measured at T1 in the observation group were (72.01 ± 1.64) mmHg and (136.42 ± 3.20) beats/minute, respectively, which were significantly lower than those in the control group [(76.31 ± 1.89) mmHg and (143.21 ± 3.45) beats/minute, t = 13.311, 11.177, both P < 0.05]. Mean arterial pressure and heart rate measured at T2 in the observation group were (69.32 ± 1.36) mmHg and (130.02 ± 2.61) beats/minute, respectively, which were significantly lower than those in the control group [(72.02 ± 1.86) mmHg, (134.09 ± 3.26) beats/minute, t = 9.077, 7.549, both P < 0.05]. Time to extubation, time to recovery from anesthesia, and time to wake up in the observation group were (7.15 ± 0.89) minutes, (10.36 ± 1.74) minutes, (26.76 ± 8.32) minutes, respectively, which were significantly shorter than those in the control group [(9.20 ± 1.43) minutes, (8.23 ± 1.56) minutes, (39.42 ± 12.15) minutes, t = 9.428, 7.060, 6.659, P < 0.05]. The incidence of agitation in the observation group was significantly lower than that in the control group [10.00% (6/15) vs. 25.00% (15/60), χ2= 4.675, P < 0.05)]. Duration of agitation in the observation group was significantly shorter than that in the control group [(6.75 ± 1.32) minutes vs. (10.85 ± 2.14) minutes, t = 12.631, P < 0.05]. At 3, 12 and 24 hours after surgery, Visual Analogue Scale score in the observation group was (2.15 ± 0.34) points, (1.45 ± 0.38) points and (1.08 ± 0.26) points, respectively, which were significantly lower than that in the control group [(3.24 ± 0.53) points, (2.16 ± 0.39) points, (1.54 ± 0.32) points, t = 13.409, 10.100, 8.642, all P < 0.05]. Conclusion:Dexmedetomidine hydrochloride has little effect on hemodynamics during surgery in children patients with hernia subjected to laparoscopic hernia repair, with fast recovery from anesthesia, a low incidence of agitation, and obvious postoperative analgesia.