소아에서 깊은 마취하 발관과 각성후 발관에 따른 기도합병증 및 산소포화도의 변화

Abstract

BACKGROUND Tracheal extubation can be performed while patients are deeply anesthetized or when they are awake. Each technique has its own advantages and disadvantages. But necessity for deep extubating conditions, and what level of anesthesia is adequately deep, is still controversial. Clinical conditions of patients or the preference of the anesthesiologist has dictated the choice of extubation technique. METHOD Anesthesia was induced and maintained as usual manners. The 49 healthy children between 3 and 12 year of age undergoing tonsillectomy and adenoidectomy were randomly assigned to group 1(extubation at 1 MAC of enflurane) and group 2(awake extubation). SpO2 and airway-related complications(cough, breath-holding, airway obstruction, and laryngospasm) were observed for 5 minutes after extubation with 100% O2 by mask, and SpO2 and heart rate were measured for 90 seconds during transportation to the recovery room with room air breathing. RESULTS The total incidence of airway-related complications in group 2 were higher than in group 1. However, group 1 showed severer complications than in group 2 such as airway obstruction and laryngospasm. There was no differences between the two groups in SpO2 and heart rate changes with 100% O2 mask just after extubation and during transportation. Group 1 showed higher SpO2 than group 2 upon arrival in the recovery room. CONCLUSION We concluded that in healthy children undergoing elective oral surgery, airway-related complications are likely to be influenced more by the skill, experience and preference of the anesthesiologist than by the method alone.