Objective    To find a more suitable approach to pediatric anesthesia during laparoscopic operation to alleviate str

ess response.     Methods    Forty patients

1 to 3 years of age

ASA grade Ⅰ-Ⅱ

underwent general anesthesia (group GA) and combined general epidural anesthesia (group GEA) during their laparoscopic operation. Heart rate (HR)

mean arterial pressure (MAP)

ECG

SPO

2

PETCO

2

blood gas

plasma epinephrine

plasma norepinephrine

plasma IL-6 and IL-10 were monitered and recorded five minutes before anesthesia (T

0

)

pre-pneumoperitoneum (T

1

)

5 min after pneumoperitoneum (T

2

)

30 min after pneumoperitoneum (T

3

)

30 min after operation (T

4

) and 24 h after operation (T

5

).     Results    (1) HR

MAP of group GA were increased obviously at T

2

T

3

T

4

compared to T

0

(P0.05)

but of no significant change in group GEA (P0.05). Significant difference was found at T

1

T

2

T

3

and T

4

between group GA and group GEA (t=4.749

10.349

13.632

10.051

P0.01). (2) In both groups

the concentration of plasma epinephrine and norepinephrine were increased gradually. Plasma epinephrine and plasma norepinephrine of group GA were higher than those of group GEA (P0.05). (3) Plasma IL-6 at T

2

T

3

T

4

got higher than that at T

1

in both groups (P0.05)

then decreased at T

5

but it showed no significant change between two groups at each time point (P0.05). Plasma IL-10 at T

1

T

2

T

3

T

4

were higher than that at T

0

in both groups (P0.05). Plasma IL-10 of group GEA at T

3

-T

5

was higher than that of group GA (P0.05).     Conclusion    Serious stress response may occur during pediatric laparoscopic surgery. Compared to single general anesthesia

general anesthesia combined with epidural block maintains more stable hemodynamics

exerts more effective postoperative analgesia

shortens postoperative recovery and reduces surgical stress response.