| Objective: Comparison of intraoperative hemodynamics and postoperative recovery characteristics of desflurane versus propofol-remifentanil in pediatric patients undergoing strabismus surgery.Methods: 100 healthy(ASA physical status I or II)children under going strabismus surgery from June 2017 to December 2017 were studied,with the standard of 5-8 yr of age and 18～28kg weight.Patients were randomly assigned to two groups: desflurane(DES Group,50 cases)and propofol-remifentanil(TIVA Group,50 cases).All patients were given atropine(0.01～0.02mg·kg-1)and methylprednisolone(1 mg·kg-1).All patients were intravenous induced of propofol(2.5-3mg ·kg-1),rocuronium(0.6-0.8mg·kg-1)and remifentanil(1ug·kg-1).In the TIVA group,continuous intravenous infusion of propofol(80～120ug ·kg-1·min-1)and remifentanil(0.2～0.4ug·kg-1·min-1)were started immediately after intravenous induction of anesthesia.In DES group,anesthesia was continued with desflurane in 100% oxygen using flows of 1L·min-1 in a circle system.The end-tidal concentration of desflurane was maintained at approximately 6～8vol%.Five minutes before the end of surgery,patients in both groups were given tramadol(1～2mg·kg-1).0.4% oxybuprocaine was added to the eye at the end of the operation.The mean arterial pressure(MAP),heart rate(HR)and oxygen saturation(Sp O2)were record at these time points,entrance time(T1),induction time(T2),intubation time(T3),3 minutes after intubation(T4),the begin of the surgery(T5),pulling lateral rectus(T6),pulling medial rectus(T7),at the end of the surgery(T8),extubation time(T9),leave the operating room(OR).All the patients’ spontaneous respiratory recovery time,involuntary body movement time,follow instructions open eyes time,extubation time and instruction response time were recorded.In the post anesthesia recovery unit(PACU)a blinded,independent observer,who was not aware of the administered anesthesia technique,objectively evaluated recovery using Aldrete’s score every 5 min.Results: 1.There was no significant difference in age,gender,height,weight,operation time and anesthesia time between group DES and group TIVA.2.Comparison of hemodynamics: The HR of the two groups were maintained within ±20% of which before anesthesia induction.HR of DES group were higher than TIVA group in the time t5 to t7 and t9 to t10,which had a significant difference between the two groups(p <0.05).The MAP of DES group and TIVA group were maintained within ±20% of which before the induction of anesthesia,which had no significant difference between the two groups(p <0.05).3.The indicators of recovery time: The time to cough,movement,extubation,eye opening,answering,response command and orientation were found to be lesser in group DES than in group TIVA(p < 0.01).4.Comparison of the OCR incidence: The incidence of OCR in the two groups had no statistically significant difference(p >0.05).5.Comparison of postoperative adverse effects: No significant difference in postoperative cough,nausea,vomiting,restlessness and drowsiness were found between the two groups(p >0.05).Conclusions: Hemodynamics were stable when continuous inhalation of desflurane was used to maintain anesthesia in children with strabismus surgery.The postoperative time was shorter and the incidence of the adverse effects had no significant difference in patients with desflurane anesthesia. |
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