Study On The Safety Of Extubation In Children Undergoing Tonsillectomy Under Appropriate Anesthesia Depth

Objective: To investigate pediatric adenotonsillectomy in children with appropriate depth of anesthesia surgery has not wake up until the excitement period under light anesthesia(NT value of 47-64,NT stage D0-D1)in children with two consecutive end expiratory carbon dioxide waveform for children with respiratory signs after extubation criteria for extubation were observed at the children the recovery time,hemodynamic changes and postoperative restlessness and respiratory related complications,to evaluate the program in pediatric adenotonsillectomy safety operation,lay the foundation for the new case of tracheal extubation.Method: Anesthesia of low temperature plasma adenotonsillectomy in children with 120 cases,were randomly divided into two groups,namely the appropriate anesthesia extubation group(group S)and tracheal extubation under sedation group(Z group),S group at the appropriate depth of anesthesia in children has not wake up until the period of the shallow Ma Zuixing Fen(NT value of 47-64,NT stageD0-D1)respiratory signs of extubation,Z group on patients under sedation(NT value of 65-94,NT stage B0-C2)the recovery of spontaneous breathing smoothly,the tidal volume was 6ml/kg,respiratory frequency warping,extubation,recording two groups of children into the operation room(T1),at the end of operation(T2),extubation time(T3)and return the anesthesia recovery room(T4)systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR),and hand assisted breathing time(Ta),the end of surgery to send from the operation room time(Tb)and anesthesia recovery room residence time(Tc),evaluate the degree and score returned to anesthesia recovery room of postoperative agitation(PAED score),to observe the anesthesia recovery period is the emergence of cough,airway spasm the upper respiratory tract obstruction,low oxygen saturation and other respiratory complications.Result:(1)There was no significant difference in gender,age,body weight,transfusion volume,blood loss,time of anesthesia between the two groups(P > 0.05).(2)Hemodynamics: Comparison of S group and Z group: no difference between T1 and T2 at two time points SBP,DBP,MAP,HR difference(P > 0.05);there were significant differences in T3,T4 two time points SBP,DBP,MAP,HR difference(P < 0.05);S group and Z group group comparison: compared with T1,T2 and T3 had no statistical significance,T4 SBP,DBP,MAP,HR difference(P > 0.05);compared with T2,T3 and T4 have statistical significance of SBP,DBP,MAP,HR difference(P<0.05)..(3)The recovery period occurred respiratory complication rate comparison:anesthesia appeared difference between cough and airway laryngeal spasm situation was statistically significant(P<0.05);the difference in PACU had respiratory tract obstruction and low blood oxygen saturation were not statistically significant(P>0.05);(4)Extubation after manual assisted breathing time(Ta)with statistically significant difference between S group and Z group(P<0.05);(5)The end of the operation to send from the operation room time(Tb)and residence time in anesthesia recovery room(Tc)there was no significant difference between S group and Z group(P>0.05).(6)There was a significant difference between the S group and the Z group in the degree of postoperative agitation and score(PAED score)(P<0.05).Conclusion: In pediatric adenotonsillectomy,proper anesthesia extubation(NT value of 47-64,NT D0-D1,to stage)with 2 consecutive end expiratory carbon dioxide waveform for children with respiratory signs after extubation of the standard extraction gas conduit,more stable hemodynamics,surgery after the agitation rate is lower,lower incidence of respiratory complications,high safety,and the end of surgery to send from the operation room time and in PACU stay did not extend,but the appropriate depth of anesthesia extubation after controlled auxiliary respiratory support time.