The effect of transverse abdominal plane block combined with parecoxib sodium on emergence agitation in children:a randomized clinical study

Objective To discuss the effect of transverse abdominal plane block combined with parecoxib sodium on the incidence of emergency agitation (EA) in pediatric laparoscopic hernia repair surgery. Methods A total of 120 children, aged from 1 to 3 years, scheduled for hernioplasty were randomly divided into 4 groups (30 cases in each group), transverse abdominal plane block combined with parecoxib sodium group (TP group), transverse abdominal plane block group (T group), parecoxib group (P group) and control group (C group). The TP group and P group at the time of anesthesia induction were intravenously injected using 0.9 mg/kg parecoxib respectively. After the induction, the children in TP group and T group were injected with 1 mL/kg 0.25% ropivacaine in the transverse abdominal muscle plane, and the children in P group and C group were injected with the same amount of normal saline. The operation condition, emergence agitation, pain, sedation and adverse reaction after 24 h of operation were recorded. Results There was no significant difference in the duration of anesthesia, operation, respiratory recovery and extubation among the four groups (P>0.05). HR and MAP of TP group, P group and T group were lower than those of C group during the operation (P<0.05), which were lower than those of P and T groups (all P<0.05). The incidences of the agitation in P group and T group were lower than that in C group (all P<0.05). The incidence of the agitation in TP group, P group, T group and C group was 16.67%, 26.67%, 26.67% and 53.33%, respectively. There were significant differences between the four groups (all P<0.05). Compared with the FLACC and Ramsay scores in C group, which in P and T groups decreased significantly (all P<0.05). Compared with the P group and T group, the FLACC scores in groups at T5, T6 and T7 decreased (all P<0.05), and the Ramsay scores at T5 was significantly higher than that in p group and T group (all P<0.05). There were no adverse reactions such as delayed recovery and drowsiness in 4 groups. Conclusion Transverse abdominal plane block combined with parecoxib sodium can significantly reduce the incidence of EA in children, with more stable intraoperative circulation and good safety, which has important clinical reference significance.