Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2022; 10(24): 8506-8513
Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8506
Effects of propofol combined with lidocaine on hemodynamics, serum adrenocorticotropic hormone, interleukin-6, and cortisol in children
Song Shi, Lu Gan, Chun-Nv Jin, Rong-Fang Liu
Song Shi, Lu Gan, Rong-Fang Liu, Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei Province, China
Chun-Nv Jin, Department of Anesthesiology, Baoding Maternal and Child Health Hospital, Baoding 071000, Hebei Province, China
Author contributions: Shi S, Lu G and Liu RF designed this retrospective study and wrote the paper; Shi S and Liu RF contributed equally to this study, and considered as so-first authors; Shi S, Lu G, Liu RF and Jin CN were responsible for sorting the data.
Institutional review board statement: This study was reviewed and approved by the Affiliated Hospital of Hebei University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rong-Fang Liu, MD, Attending Doctor, Department of Anesthesiology, Affiliated Hospital of Hebei University, No. 212 Yuhua East Road, Baoding 071000, Hebei Province, China. liurf2021@163.com
Received: January 17, 2022
Peer-review started: January 17, 2022
First decision: March 3, 2022
Revised: March 17, 2022
Accepted: July 18, 2022
Article in press: July 18, 2022
Published online: August 26, 2022
Processing time: 210 Days and 16.9 Hours
Abstract
BACKGROUND

Children are a unique patient population. Anesthesia for pediatric abdominal surgery has long been achieved mainly with intravenous amiodarone and propofol alone or combined with other anesthetics. The incidence of complications and postoperative adverse reactions is relatively high owing to the imperfect development of various protocols for children. Choosing the most appropriate anesthesia program is an important means of reducing adverse reactions.

AIM

To explore the clinical value of propofol combined with lidocaine-assisted anesthesia in pediatric surgery.

METHODS

A total of 120 children who underwent abdominal surgery at our hospital from January 2016 to March 2018 were selected and divided into groups A and B using the random number table method, with 60 patients in each group. Group B received ketamine for anesthesia, while group A received ketamine, propofol, and lidocaine. The pre- and postoperative heart rate (HR); mean arterial pressure (MAP); arterial oxygen saturation (SpO2); serum adrenocorticotropic hormone (ACTH), interleukin-6 (IL-6), and cortisol (Cor) levels; restlessness score during the recovery period [Paediatric Anesthesia Emergence Delirium Scale (PAED)]; and adverse reactions were compared between the two groups.

RESULTS

The HR, MAP, and SpO2 Level at five minutes before initiating anesthesia were compared between groups A and B, and the difference was not statistically significant (P > 0.05). At 10 and 20 minutes after anesthesia initiation, the HR and MAP were lower in group A compared with group B (P < 0.05). The differences in preoperative serum ACTH, IL-6, and Cor levels between groups A and B were not statistically significant (P > 0.05); however, the postoperative serum ACTH, IL-6, and Cor levels in group A were lower compared with group B (P < 0.05). Furthermore, the visual analog scale scores of group A at 2 h and 8 h postoperative were lower than those in group B, and the differences were statistically significant (P < 0.05). The mean PAED score in group A was lower than that in group B (P < 0.05), and the incidence of restlessness in group A was 23.33% lower than that in group B (36.67 %) (P < 0.05). The incidence of adverse reactions was lower in group A than in group B (6.25% vs 16.25%).

CONCLUSION

The anesthetic effect of propofol combined with lidocaine and ketamine in pediatric surgery was better than that of ketamine alone, and had less influence on hemodynamics and pediatric stress response indices, lower incidence of restlessness in the recovery period, and lower incidence of adverse reactions.

Keywords: Ketamine; Propofol; Lidocaine; Anesthesia; Children

Core Tip: Propofol is a general anesthesia drug with fast onset, short duration, and fast recovery, but it can cause obvious pain during injection. Injection pain can be reduced by lidocaine combined with propofol. This study was to observe the anesthetic effect of propofol combined with lidocaine in pediatric surgery, and to provide guidance and basis for clinical practice.