Discussion
laryngeal edema, irritation, choking, hypoxia, apnea, postoperative agitation, cough, laryngospasm, agitation, tonsil/adenoids, airway complications, OSAS, respiratory complications
LARYNGEAL EDEMA, ADVERSE EVENTS, HYPOXIA, CHOKING, HEMODYNAMIC INSTABILITY, BRONCHOSPASM, PULMONARY EDEMA, LARYNGOSPASM, PULMONARY ATELECTASIS, RESPIRATORY COMPLICATIONS, COMPLICATIONS
In this study, we finally analyzed the data of 423 children with different head-high lateral positions to drain the secretions, blood and surgical irrigation fluid from the pharynx of the children through the positions in order to reduce the occurrence of adverse events such as respiratory complications and post-operative agitation after extubation. In our study, a head-high 15° lateral position and a head-high 30° lateral position during post-operative extubation in children with OSAS significantly reduced the risk of post-extubation choking and hypoxia in children. In addition, the occurrence of agitation after awakening of the children was significantly reduced.The clinical morbidity of OSAS in children is high and its surgical treatment is based on the removal of enlarged tonsils and adenoids. The smooth resuscitation period is crucial for the safety of the children's life during extubation, especially in the post-operative period for children with OSAS. The vital signs of the children should be closely monitored after extubation. Post-extubation complications include bronchospasm, severe cough, laryngospasm, decreased oxygen saturation, laryngeal edema, pulmonary atelectasis, pulmonary edema, apnea and hemodynamic instability [In this study, the lateral position was combined with the head-high supine position and divided into head-high 0°, head-high 15° and head-high 30° lateral position for extubation. It has been demonstrated that after tonsil/adenoids removal surgery under general anesthesia in pediatric patients, the SpOIn addition, the incidence of choking (46.5% and 40.7%, respectively) and SAS score (4.6 and 4.6, respectively) in children with head-high 15° lateral position and head-high 30° lateral position were also significantly lower than the incidence of choking (60.3%) and SAS score (4.9) in children with head-high 0° lateral position. This may be due to the fact that extubation in the lateral position allows secretions and blood to flow automatically from the mouth and nose, reducing their irritation to the children's pharynx [However, in our study, there was no significant difference between the two groups in either the incidence of airway complications such as choking and laryngospasm or the incidence of adverse events such as postoperative agitation in the head-high 15° lateral position compared with the head-high 30° lateral position (all This study has some limitations. Firstly, limited by the conditions, we did not use double-blind RCT, which may have some subjective error; Secondly, we selected children aged 3–14 years, and there are some differences in the cognitive levels of the children, and the results obtained may be more accurate if the conditions allow for grouping by different age groups.