Comparison with sevoflurane' inhalation and propofol combined with ketamine total venous anesthesia in pediatric laparoscopic surgery of oblique inguinal hernia / 中国医师进修杂志

ABSTRACT

Objective To evaluate sevoflurane inhalation and propofol combined with ketamine total venous anesthesia in pediatric laparoscopic surgery of oblique inguinal hernia.Methods Seventy ASA Ⅰ children were randomly divided into two groups,35 children in every group.Children in group S were appliedsevoflurane inhalation[the minimum alveolar concentration(MAC)of sevoflurane was 1.0-1.5],children in group PK were applied ketamine inhalation and total venous anesthesia of propofol[80μg/(kg·min)]with ketamine[20μg/(kg·min)].Compared the time of anesthesia induction,tracheal catheter extubation,anesthesia recovery between the two groups.The mean arterial pressure(MAP),heart rate,pulse oxygen saturation(SpO_2)during anesthesia were compared.During 2 days after operation,the adverse effects such as nausea and vomit,lower grade of sleep quality were also compared.Results Compared with group PK,the time of anesthesia induction,tracheal catheter extubation and anesthesia recovery in group S were shorter (P<0.05),the incidence of emergence agitation in group S was higher(20.0%,7/35 vs 2.9%,1/35)(P<0.05).But nausea(17.1%,6/35),vomit(31.4%,11/35)and lower grade of sleep quality(54.3%,19/35)were higher in group PK than those in groups(all 2.9%,1/35)at 1 day after operation(P<0.05).The incidence of lower grade of sleep quality at2 days after operation in group PK(14.3%,5/35)was higher than that in group S(0)(P<0.05).Cardiovascular effects of children,such as MAP and heart rate during the period of tracheal catheter extubation in group S was higher than that in group PK.Conclusion Sevoflurane inhalation and propofol combined with ketamine total venous anesthesia in pediatric laparoscopic surgery of oblique inguinal hernia still has some disadvantages,the anesthesia technology is selected by anesthesia method and medicine combination.