The Effect Of Tracheal Extubation In Lateral Position Under Deep Anesthesia On Respiratory Complications Of Children During General Anesthesia Recovery Period

Objective:To observe the effect of tracheal extubation in lateral position under deep anesthesia on respiratory complications of children during general anesthesia recovery period,and to evaluate the quality of recovery period of general anesthesia in children with tonsillectomy/adenoidectomy.Methods:A randomized double-blind control design was used in this experiment.Ninety-three patients with tonsillectomy/adenoidectomy aged 3-8 years,ASA grade I or II,were randomly divided into three groups?n=31?:awake and supine position group?group AS?,Deep and supine position group?group DS?,Deep and lateral position group?group DL?.All patients underwent tonsillectomy/adenoidectomy under general anesthesia with tracheal intubation.The group AS underwent tracheal extubation in awake and supine position.The group DS underwent tracheal extubation in supine position under deep anesthesia.The group DL underwent tracheal extubation in lateral position under deep anesthesia.Observe the respiratory complications of children during general anesthesia recovery period.Cough Score were evaluated at entering PACU?T₀?,1 min?T₁?,3 min?T₂?,5 min?T₃?,15 min?T₄?,30 min?T₅?after extubation and transfer out of the PACU?T₆?.MAP and HR were evaluated from T₁ to T₆.Record the number of analgesics accepted during general anesthesia recovery period.Sedation-Agitation score?SAS?were evaluated from T₁ to T₆.Record the number of sedative drugs accepted during general anesthesia recovery period.Record the extubation time,recovery time,and PACU residence time of three groups.Results:Compared with group DS,the incidence of respiratory obstruction was lower in group DL?P<0.05?.Compared with group AS,the incidence of severe cough was lower in group DS and DL?P<0.05?.Compared with group AS,the incidence of Percutaneous oxygen saturation?SpO₂?<95%was lower in group DS and DL?P<0.05?.The incidence of respiratory depression and asphyxia was not statistically significant in three groups?P<0.05?.Compared with T₀,MAP from T₁ to T₆ were increased in group AS?P<0.05?.Compared with group AS,MAP from T₁ to T₆ were decreased in group DS and DL?P<0.05?.Compared with T₀,HR from T₁ to T₆ were increased in Group AS?P<0.05?,HR from T₁ to T₄ were increased in Group DS?P<0.05?,HR at T₁ and T₅ were increased in Group DL?P<0.05?.Compared with Group AS,HR from T₁ to T₆ were decreased in Group DS and DL?P<0.05?.Compared with group AS,the number of patients receiving analgesics during the recovery period of general anesthesia was significantly reduced in Group DS and DL?P<0.05?.Compared with Group AS,SAS scores at T₁ and T₄ were decreased in Group DS?P<0.05?,SAS scores at T₁?T₂ and T₄ were decreased in Group DL?P<0.05?.Compared with group AS,the number of patients receiving sedative drugs during the recovery period of general anesthesia was significantly reduced in Group DS and DL?P<0.05?.Compared with Group AS,Group DS and DL had shorter time in PACU?P<0.05?.Conclusion:Tracheal extubation in lateral position under deep anesthesia can significantly reduce the respiratory complications in patients underwent tonsillectomy/adenoidectomy,and improve the quality of anesthesia recovery period,which is worthy of clinical application.