RESUMEN
OBJECTIVE: We explored the use of ultrasonography in determining the minimal transverse diameter of the subglottic airway (MTDSA) for the purpose of choosing an appropriate model of reinforced cuffed endotracheal tube. METHODS: A total of 110 pediatric patients who received general anesthesia and tracheal intubation for selective surgeries at the hospital from February 2019 to February 2022 were chosen. They were then randomly assigned to three groups: 39 in the MTDSA group, 35 in the age formula group, and 36 in the height formula group. We assessed how accurately the appropriate endotracheal tube model was predicted in each group and compared their predictive performance. RESULTS: The age range of the enrolled pediatric patients was 3-6 years old. The ultrasonic measurement method demonstrated a prediction accuracy of 87.18%, while the age formula method and height formula method exhibited lower accuracy rates of 54.29% and 47.22%, respectively. Notably, the ultrasonic measurement method outperformed the other two methods significantly (P < 0.05). In the MTDSA group, 2 patients had their catheters changed during anesthesia, and the proportion of patients who changed their catheters was 5.13%. In the MTDSA group, 6 catheters were replaced, and the frequency of catheter replacement was 15.38%. In contrast, these percentages were much higher in the age formula group, at 31.43% and 45.71%, and in the height formula group, at 36.11% and 52.78%. The latter two groups had significantly higher values than the MTDSA group (P < 0.05). Regarding complications such as hoarseness, laryngeal edema, aspiration, and laryngospasm, the MTDSA group experienced a notably lower total incidence of 7.69% compared to the 37.14% in the age formula group and 41.67% in the height formula group, demonstrating statistical significance (P < 0.05). CONCLUSION: The ultrasonic measurement technique employed in MTDSA exhibits impressive precision when it comes to forecasting the specific model of a reinforced cuffed endotracheal tube for pediatric patients. This enhanced accuracy contributes significantly to minimizing the need for tube replacements during anesthesia and the associated complications. It holds immense importance in assisting clinicians in selecting the most appropriate pediatric endotracheal tube model for anesthesia induction.
RESUMEN
OBJECTIVE: Anesthesia was reported to be associated with lowered postoperative sleep quality in adults, but its effect on teenager was less understood. This study was conducted to explore the association between postoperative sleep quality and general anesthesia in teenagers. METHODS: A prospective study was conducted. Teenagers aged from 12 to 16 years who were treated with general anesthesia and under urologic or otolaryngologic surgery were recruited. Healthy teenagers matched by sex and age (± 3 years) with the specific case were recruited as the controls. The Sleep Habits Questionnaire was applied to assess the sleep quality of the teenagers. We applied a logistic regression analysis to evaluate the association between general anesthesia in teenagers under elective surgery and poor sleep quality. Risk ratio (RR) and its corresponding 95% confidence interval (CI) were computed. RESULTS: A total of 212 teenagers were included comprising 106 patients with general anesthesia who underwent urologic or otolaryngologic surgery and 106 healthy controls. The male participants were accounting for 47.2% (100/212). Anesthesia duration and surgery duration in the patients were 103.7 ± 14.4 min and 162.1 ± 17.0 min, respectively. Positive associations between general anesthesia and poor sleep quality in the 1st, 3rd, and 7th postoperative days were found, and RRs and their corresponding 95%CIs were 4.87 (1.72-13.79), 3.33 (1.22-9.1), and 3.26 (1.07-9.93), respectively. However, there was a lack of statistical associations before surgery and after 14 postoperative days. CONCLUSIONS: Teenagers who were treated with general anesthesia and under urologic or otolaryngologic surgery might have poor sleep quality within 7 postoperative days.
