阜南县人民医院

Objective:To investigate and analyze the influence of caudal block combined with general anesthesia on postoperative agitation and stress responses in pediatric patients undergoing laparoscopic indirect inguinal hernia repair.Methods:A total of 108 pediatric patients who underwent laparoscopic indirect inguinal hernia repair at Fufan County People's Hospital from January 2019 to January 2022 were enrolled. They were randomly divided into the caudal block group (55 patients) and the control group (53 patients) using a random number table. The control group received general anesthesia with a laryngeal mask, while the caudal block group received caudal block combined with general anesthesia using a laryngeal mask. The mean arterial pressure (MAP), heart rate, oxygen saturation (SpO2), norepinephrine (NA) levels, and cortisol levels were observed and compared before laryngeal mask placement (T0), during pneumoperitoneum (T1), and 5 minutes after removing the laryngeal mask (T2). Pediatric anesthesia emergence delirium scale (PAED) were assessed immediately upon arrival in the Post Anesthesia Care Unit (PACU), as well as 5, 15, and 30 minutes later. Postoperative analgesic administration and adverse events were also recorded.Results:In the control group, the MAP and heart rate were significantly increased at T1 and T2 compared to T0 (P<0.05). In the caudal block group, only the MAP at T2 was significantly elevated compared to T0 (P<0.05). MAP and heart rate in the control group were significantly higher than in the caudal block group at T1 and T2 (P<0.05). The SpO2 levels in the control group at T1 and T2 were significantly decreased compared to T0 (P<0.05) and were significantly lower than in the caudal block group (P<0.05). Both groups displayed significantly elevated levels of NA and cortisol at T1 and T2 compared to T0 (P<0.05), but the levels in the caudal block group were notably lower than in the control group (P<0.05). Upon arrival at PACU and at 5 and 15 minutes postoperatively, the PAED scores in the caudal block group were significantly lower than in the control group (P<0.05). Incidences of postoperative tramadol administration, nausea and vomiting, intraoperative movement, postoperative agitation, and airway auxiliary management were all notably higher in the control group compared to the caudal block group (P<0.05).Conclusion:Caudal block combined with general anesthesia using a laryngeal mask for pediatric laparoscopic indirect inguinal hernia repair can reduce postoperative agitation, decrease the rate of anesthesia-related adverse reactions, provide effective postoperative analgesia, and suppress intraoperative stress responses, thus offering superior anesthetic outcomes.