Effect of Different Positions During Extubation on Incidence of Hypoxemia in the Peri Extubation Period

Assiut University

Status: Not yet enrolling

Conditions: Hypoxia

Treatments: Procedure: positioning during peri-extubation

Study type: Interventional

Funder types: Other

Identifiers

NCT07231887

ENT2025

Details and patient eligibility

About

Pediatric Obstructive Sleep Apnea Syndrome (OSAS) is common, often due to enlarged tonsils/adenoids. Tonsillectomy/adenoidectomy frequently performed under GA with tracheal intubation due to the age of children. Risk of hypoxemia and respiratory complications during the peri-extubation period is high.

Full description

The most common disorder of sleep apnea in children is obstructive sleep apnea syndrome (OSAS), characterized by interrupted breathing and partial or complete obstruction of the upper airway, the main factor is the enlargement of the tonsils and adenoids in the pediatric pharynx. The clinical symptoms are snoring, and open-mouth breathing, then resulting in hypoventilation and hypoxemia. Due to the age of children, tonsillectomy and adenoidectomy are often performed under general anesthesia with tracheal intubation. The risk of hypoxemia and the degree of oxygen saturation reduction are bigger when the mask was removed in the supine position, and the most serious complication also occurred in the supine position. Therefore, the lateral position is preferable to the supine position for mask removal. There are few reports on the effect of different positions on complications related to tracheal extubation after tonsillectomy and adenoidectomy under general anesthesia in children with OSAS. In this study, we will investigate and compare whether the use of lateral position or semi-prone position impact on the occurrence of choking, agitation, decreased pulse oxygen saturation - (SpO2) and the oral and nasal secretions during the awakening period.

Enrollment: 262 estimated patients

Sex: All

Ages: 2 to 10 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 2-10 years
• American Society of Anesthesiologists physical status classification (ASA) I - II
• Patients scheduled for ENT procedures involving tonsillectomy, adenoidectomy or adenotonsillectomy

Exclusion criteria

• • Patient legal guardian refusal to participate in the study.

  • Children with cardio-pulmonary disease

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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262 participants in 2 patient groups

Group L (lateral position):

Active Comparator group

Description:

ENT surgery patients positioned laterally with head in zero position after completion of surgery and before extubation till full recovery and discharge from PACU.

Treatment:

Procedure: positioning during peri-extubation

Group S (Sim' position):

Active Comparator group

Description:

ENT surgery patients positioned in semi-prone position after completion of surgery and before extubation till full recovery and discharge from PACU.

Treatment:

Procedure: positioning during peri-extubation