Application Research Of Enhanced Recovery After Surgery On Perianesthesia Of Cleft Lip And Palate Operation In Infants

ObjectiveTo evaluate the effect of enhanced recovery after surgery（ERAS）on perianesthesia of cleft lip and palate operation in infants by comparing the recovery outcomes after surgeries with different anesthesia schemes.MethodsTwo hundred（200）children aged from 6 months to 3 years who needed to be operated on cleft lip and palate were assigned into five groups according to the method of random number table:conservative treatment surgery group（CTS group）,preoperative optimization treatment group（Pre OT group）,intraoperative optimization treatment group（IOT group）,postoperative optimization treatment group（Post OT group）,enhanced recovery after surgery group（ERAS group）.n=40 in each group.CTS group was given routine perioperative management,Pre OT group was given optimization measures with evidence-based medical evidence before operation,IOT group was given optimization measures with evidence-based medical evidence during operation,and Post OT group was given optimization measures with evidence-based medical evidence support in postoperative treatment,Patients in ERAS group were given optimization measures with evidence-based medical evidence in preoperative treatment,intraoperative treatment and postoperative treatment.The hemodynamic index,sedation-agitation scale,and FLACC scale were monitored and recorded during the time awaken from anesthesia and 2,8,16,24 h postoperatively.Rescue analgesia rate and postoperative rate of nausea and vomiting were recorded 24 h after surgery.The severity of postoperative wound bleeding as well as days of postoperative hospital stays were also recorded.ResultsThere was no significant difference between the five groups of demographic data（gender,age）and general clinical data（Type of operation,Operation time）（P>0.05）.There were no statistically significant differences in HR,MAP,RR and Sp O₂between the five groups at each time point after surgery（P>0.05）.There was no statistically significant difference in the incidence of nausea and vomiting within 24 hours after surgery among the five groups（P>0.05）.Compared with the ERAS group,the restlessness score of the children in the other groups were higher at all time points after the operation,the severity of wound bleeding was higher,the hospital stay was longer,and the differences were all statistically significant（P<0.05）.Compared with CTS group,children in Pre OT group,IOT group,and Post OT group had lower restlessness scores,less severe wound bleeding,and shorter hospital stay at various time points after surgery,and the differences were all statistically significant（P<0.05）.There was no significant difference in restlessness score,wound bleeding severity and length of hospital stay among Pre OT group,IOT group and Post OT group（P>0.05）.Compared with the ERAS group,the FLACC score of the children in the other groups were higher at all time points after the operation,and the postoperative salvage analgesia rate was higher,and the differences were all statistically significant（P<0.05）.Compared with IOT and Post OT group,the FLACC score and postoperative salvage analgesia rate of children in CTS and Pre OT group were higher at all time points after surgery,and the differences were all statistically significant（P<0.05）.There was no significant difference in FLACC score and postoperative salvage analgesia rate between IOT group and Post OT group（P>0.05）.There was no significant difference in FLACC score and postoperative salvage analgesia rate between CTS group and Pre OT group（P>0.05）.ConclusionERAS can reduce the incidence of postoperative restlessness and the severity of wound bleeding in children with cleft lip and palate,reduce pain,shorten the length of hospitalization,and help children recover.