Background: Laparoscopic surgeries performed in steep Trendelenburg position with pneumoperitoneum cause significant intraocular pressure (IOP) elevation, posing a potential risk for perioperative ocular complications. Anaesthetic technique plays a crucial role in modulating these changes. This study compares the effects of Total Intravenous Anaesthesia (TIVA) using propofol versus desflurane-based inhalational anaesthesia on IOP and haemodynamic stability. Methodology: A prospective, randomized comparative study was conducted on 60 patients (ASA I–II) undergoing elective laparoscopic surgery. Patients were assigned to either the Propofol TIVA group (Group P, n=30) or the Desflurane group (Group D, n=30). Intraocular pressure was recorded at baseline, post-induction, after pneumoperitoneum, and at 10, 30, and 60 minutes of Trendelenburg, followed by the return to supine position. Haemodynamic parameters were also assessed. Statistical analysis was performed using t-tests and chi-square tests, with p<0.05 considered significant. Results: Baseline demographics were comparable across groups. Group D showed significantly higher IOP at all surgical stress points—after induction (p=0.01), after pneumoperitoneum (p<0.001), and during Trendelenburg at 10, 30, and 60 minutes (all p<0.001). IOP returned toward baseline after resuming supine position but remained significantly higher in Group D (p<0.001). Haemodynamic variables including mean arterial pressure showed no significant intergroup differences at any time point. Conclusion: Propofol-based TIVA is more effective in attenuating intraoperative IOP rise than desflurane anaesthesia during laparoscopic surgeries requiring pneumoperitoneum and Trendelenburg position. Both techniques provide stable haemodynamics; however, TIVA may be preferable in patients at risk for ocular hypertension or glaucoma.

Introduction: The optimal operative strategy for managing inguinal hernia (IH) in the adolescent population remains undetermined. This investigation sought to analyse and contrast the short-term perioperative results and the durable long-term prognosis among young patients suffering from IH who were treated either with minimally invasive laparoscopic hernia repair (LHR) or conventional open hernia repair (OHR). Methodology: This was a retrospective cohort study examining historical clinical and pathological characteristics of adolescent IH patients who initially received either LHR or OHR at VIMSAR, Burla between March 2018 and February 2024. Prognostic indicators associated with patient survival and outcome were isolated using univariate and subsequently multivariate Cox regression modelling. To mitigate potential selection bias, Propensity Score Matching (PSM) analysis was implemented to establish equivalent cohorts of patients from the LHR and OHR groups, matching them in a 1:1 ratio. Results: The initial cohort of adolescent IH patients comprised 122 individuals in the LHR group and 126 individuals in the OHR group. Following the execution of PSM, 94 patients were successfully matched in each study arm. Relative to the OHR cohort, the LHR group exhibited numerous advantages, including a shorter duration of hospital stay, reduced intraoperative haemorrhage, a lower incidence of total postoperative morbidities, and decreased rates of both recurrence and persistent postsurgical pain. Furthermore, the LHR cohort demonstrated markedly improved recurrence-free survival compared to the OHR group, a finding confirmed both prior to and following the PSM procedure. Conclusion: Laparoscopic management of inguinal hernia in adolescent patients represents a viable and safe therapeutic option, consistently yielding superior perioperative measures and favourable long-term outcomes.