Postoperative Effect Of Several Anesthesia Maintenances In Children Undergoing Lower Limb Surgery

Objective: To compare the influence of different anesthesia maintenances onconsciousness recovering period in children undergoing lower extremity surgery.Methods:60cases of lower extremity surgeries with endotracheal intubation, ASA Ⅰ~Ⅱ grade, aging3~8years,were divided into three groups randomly,20cases each group.Induction of anesthesia and narcotic medicines involved were exactly same.Maintenance:group S: sevoflurane inhalation (2-3%); group SF: sevoflurane (2-3%) coupled withpropofol4~6mg/kg/h. group R:remifentanil6~8ug/kg/h coupled with propofol4~6mg/kg/h. No Preoperative narcotic medicine offered, routine monitoring of electrocardiogram(ECG), noninvasive blood pressure (BP),heart rate(HR), pulseoximetry (SpO2), anddelivering low-flow oxygen(2L/min),and then sevoflurane8%inhaling induction. Afterlosing eyelash reflex, intravenous injection of midazolam0.05~0.08mg/kg, ketamine1-2mg/kg, fentanyl8-10μg/kg and vecuronium0.1-0.15mg/kg, performing endotrachealintubation after induction6minutes or more. Observing parameters: surgery lasting time,anesthesia time, consciousness recovering time, PACU time, and restlessness assessmentwith PAED scores, the incidence of postoperative nausea and vomiting, the amount ofsecretion, and the incidence of other adverse reactions. Results:1.There were nostatistically significant difference in three groups on the age, body weight, surgery lastingtime, anesthesia time, postoperative recovering time (P>0.05).2.Comparing with group Fand group R, group SF had a lower incidence of restlessness in consciousness recoveringperiod, the PAED scores among the three groups also had significant difference(P=0.021), compared with group F,the PACU time and PAED score in group SF wassignificantly lower(P=0.004,0.003). Between group F and group R, there was nosignificant difference in PAED scored restlessness incidence in the consciousnessrecovering period(P>0.05). Conclusion:Compared with sevoflurane inhalation only and remifentanil coupled with propofol,anesthesia maintained with Sevoflurane inhalationcombined propofol experienced less restlessness in consciousness recovering periodpostoperatively,moreover, the incidence of nausea and vomiting had also been reduced, nosignificant changes in the incidence of other postoperative adverse reactions.