Tonsillectomy is a frequently performed surgical procedure in children, requiring post-operative analgesia. This study evaluated the efficacy and safety of nalbuphine or sufentanil combined with dexmedetomidine for patient-controlled intravenous analgesia (PCIA) after pediatric tonsillectomy adenoidectomy. A total of 400 patients undergoing tonsillectomy with and without adenoidectomy were included in the study. Patients received a PCIA pump (0.5 mg/kg nalbuphine, 2 μg/kg dexmedetomidine and 0.9% sodium chloride to a total volume of 100 ml) for postoperative pain management were classified into Group ND (n = 200). Patients received a PCIA pump (2 μg/kg sufentanil, 2 μg/kg dexmedetomidine and 0.9% sodium chloride to a total volume of 100 ml) for postoperative pain management were classified into Group SD (n = 200). More stable hemodynamic changes were noted in Group ND than Group SD from 1 h to 48 h after operation. At 6, 12, 24, and 48 h after operation, the children in Group ND had higher Ramsay sedation scores than those in Group SD. The times to push the PCIA button in Group ND and Group SD were 2.44 ± 0.74 and 2.62 ± 1.00, showing significant differences (p = 0.041). The VASR scores of children in Group ND were significantly lower within 6, 12, and 24 h than those in Group SD (p < 0.05). The VASC scores of children in Group ND were significantly lower within four time points (2, 6, 12, and 24 h) than those in Group SD (p < 0.05). At 1st day after surgery, the children in Group ND had lower levels of serum ACTH, IL-6, and COR levels than those in Group SD (p < 0.001). The incidence rates of nausea and vomiting, and pruritus were significantly higher in Group SD than Group ND (5.00% vs. 11.00%, p = 0.028; 1.00% vs. 4.50%, p = 0.032). The total incidence rate of adverse reactions was significantly higher in Group SD than Group ND (15.00% vs. 31.00%, p = 0.0001). The study demonstrated that dexmedetomidine added to nalbuphine PCIA enhanced the analgesic effects, attenuated the postoperative pain, and reduced the stress response after pediatric tonsillectomy adenoidectomy.

Objective. To analyze the application effect of image-text communication-based healthcare education combined with shifting of attention on child patients undergoing inguinal hernia repair under general anesthesia. Methods. A total of 110 child patients with inguinal hernia treated in our hospital from January 2020 to January 2022 were selected as the study subjects and divided into the control group (CG, routine intervention measures) and the research group (RG, image-text communication-based healthcare education combined with shifting of attention) according to their preoperative intervention plans, with 55 cases each. After surgery, the child patients’ psychological status, crying and shouting situation, and occurrence of complications were evaluated to compare and analyze the intervention effect of the two groups. Results. The child patients’ positive rate and anxiety incidence rate of psychological status evaluation were obviously lower in RG than in CG (P < 0.05), and the daily frequency of crying and shouting was significantly lower in RG than in CG (P < 0.05); the single time of crying and shouting was significantly shorter in RG than in CG (P < 0.05); after surgery, child patients in the two groups had different degrees of infections, subcutaneous emphysema, and scrotal edema, but the total incidence rate of these complications was obviously lower in RG than in CG (P < 0.05); after surgery, no significant between-group difference in child patients’ FLACC scores immediately after being transferred to the ward was observed (P > 0.05), and at postoperative 1 h, 3 h, and 5 h, the FLACC scores of RG were obviously lower than those of CG (P < 0.05); and according to the investigation results, the total satisfaction and number of very satisfied parents in RG were greatly higher than those in CG (P < 0.05). Conclusion. Before child patients undergoing inguinal hernia repair under general anesthesia, implementing image-text communication-based healthcare education combined with shifting of attention can effectively improve the child patients’ postoperative psychological status and crying and shouting situation and is conducive to preventing postoperative infections, pain, and other complications and promoting postoperative recovery. The combined intervention has potential utility in reducing child patients’ high-risk adverse reactions during the perioperative period and ensuring smooth operation, which is generally recognized by the child patients’ family members.