Effects of anesthesia maintenance on the perioperative period of robot-assisted pediatric pyeloplasty with enhanced recovery after surgery mode
Yang Kangning, Ge Wenchao, Li Chunxiu, et al
1.Department of Anesthesiology, Shanxi Medical University, Shanxi, Taiyuan 030000, China; 2.Department of Anesthesiology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China; 3. Graduate School, North China University of Science and Technology, Hebei, Tangshan 063210, China; 4. Department of Pediatrics Urology Surgery, Senior Department of Pediatrics, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
Abstract: 【Abstract】 Objective To explore the effects of different anesthesia maintenance methods undergoing robot-assisted pediatric pyeloplasty in enhanced recovery after surgery (ERAS) mode. Method From October 2020 to October 2021, children with hydronephrosis aged 3 to 12 years old who admitted robotassisted laparoscopic pyeloplasty of the Seventh Medical Center of the PLA General Hospital, they were divided at random into two groups: intravenous anesthesia maintenance group (n=30) and inhalation anesthesia maintenance group (n=29). Changes in perioperative hemodynamic, the extubation time of emergence from anesthesia, postoperative emergence delirium and pain scores, and adverse reaction were compared between the two groups. Repeated measure ANOVA, t-test, Rank-sum test, χ2 test or Fisher's exact test were used for statistical analysis. Result ① Repeated measurement ANOVA showed that the meanarterial pressure in the intravenous group and inhalation group [pneumoperitoneum 5 min: (83±10) vs(81±8) mmHg, immediately after extubation: (81±10) vs (87±8) mmHg], heart rate [before skin resection:(78±16) vs (88±11) times/min, immediately after extubation: (123±18) vs (125±13) times/min] at differentperioperative time points were statistically significant differences (mean arterial pressure: Ftime=10.174,P<0.001; Fgroup=4.880, P=0.031; Ftime*group=2.393, P=0.042; heart rate: Ftime=61.159, P<0.001; Fgroup=15.956,P<0.001; Ftime*group=5.129, P<0.001). ② The extubation time after operation was significantly longer in theintravenous anesthesia group than that in the inhalation anesthesia group [(31±13) vs (23±7) min, t=2.872,P=0.006]. ③ No statistically significant differences were observed between the two groups with respectto the emergence agitation scores at each time points (all P>0.05). The rate of painless 1 h after operationin intravenous anesthesia maintenance group was significantly higher than that in the inhalation anesthesiamaintenance group (66.7% vs 37.9%, Z=-2.262, P<0.05). ④ The children of postoperative anesthesia relatedadverse reactions did not show any statistical difference between the two groups (P>0.05). ConclusionAmong children undergoing robot-assisted laparoscopic pyeloplasty with ERAS mode, children in intravenous anesthesia maintenance have a longer time to wake up, but have more stable perioperative hemodynamics and lower postoperative pain than those in the inhalation anesthesia maintenance.
杨康宁 葛文超 李春秀 卢彦 郭航 陶天 李海文 马亚群. 麻醉维持方式对加速康复外科模式下机器人辅助小儿肾盂成形手术围术期的影响[J]. 发育医学电子杂志, 2022, 10(4): 261-267.
Yang Kangning, Ge Wenchao, Li Chunxiu, et al. Effects of anesthesia maintenance on the perioperative period of robot-assisted pediatric pyeloplasty with enhanced recovery after surgery mode. Journal of Developmental Medicine(Electronic Version), 2022, 10(4): 261-267.
2022, Vol. 10 
