Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (4): 261-267 DOI: 10.3969/j.issn.2095-5340.2022.04.003 |
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| 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
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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
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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). Conclusion Among 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.
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Received: 24 November 2021
Published: 29 July 2022
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