Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial

Abstract Objectives To verify whether propofol-assisted deep extubation is associated with fewer complications in pediatric patients undergoing dental treatment. Materials and methods This prospective study enrolled 60 pediatric candidates undergoing elective dental interventions, with randomized al...

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Main Authors: Wei Cui, Xiang Zhang, Ying Shang, Yun Liu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-03170-3
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author Wei Cui
Xiang Zhang
Ying Shang
Yun Liu
author_facet Wei Cui
Xiang Zhang
Ying Shang
Yun Liu
author_sort Wei Cui
collection DOAJ
description Abstract Objectives To verify whether propofol-assisted deep extubation is associated with fewer complications in pediatric patients undergoing dental treatment. Materials and methods This prospective study enrolled 60 pediatric candidates undergoing elective dental interventions, with randomized allocation to either deep extubation (DE; n = 30) or awake extubation (AE; n = 30) protocols. The primary endpoint was the incidence of at least 1 respiratory adverse event, whereas time to extubation (TOE), time to wake-up (TOW), hemodynamic fluctuations during extubation, incidence of emergence agitation (EA), nasal obstruction, epistaxis, sore throat, and hoarse voice after extubation were the secondary endpoints. Results The DE group reported significantly lower incidence of at least 1 respiratory adverse event (0.0% VS 23.3%, P = 0.016). The TOE was significantly shorter in the DE group, averaging 2.78 ± 0.87 min, compared to 5.50 ± 1.01 min in the AE group (P < .001). The TOW was longer in the DE group, with an average of 15.03 ± 3.44 min compared to 10.63 ± 1.52 min in the AE group (P < .001). The average value of mean arterial pressure (AVMAP) during extubation was lower in the DE group at 74.70 ± 13.35 mmHg, compared to 87.43 ± 15.31 mmHg in the AE group (P < .001). The average value of heart rate (AVHR) in the DE group was 108.37 ± 13.41 bpm, while in the AE group, it was 127.93 ± 20.74 bpm (P < .001). Additionally, the rates of sore throat and hoarse voice were significantly lower in the DE group (6.7% and 3.3%) than in the AE group (27% and 30%). Conclusions For pediatric patients undergoing dental treatment, propofol-assisted deep extubation is superior, allowing for less extubation time without increasing airway complications. This technique provides a smoother extubation with fewer hemodynamic fluctuations and lower incidences of voice hoarseness and persistent coughing, provided that certain rules for deep extubation are followed.
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spelling doaj-art-8a2b435b5a2845b5af24552360a7e9bf2025-08-20T04:01:35ZengBMCBMC Anesthesiology1471-22532025-07-012511810.1186/s12871-025-03170-3Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trialWei Cui0Xiang Zhang1Ying Shang2Yun Liu3Department of Stomatology, The No.2 Hospital of BaodingDepartment of Stomatology, The No.2 Hospital of BaodingDepartment of Anesthesiology, The No.2 Hospital of BaodingDepartment of Anesthesiology, Peking University School and Hospital of StomatologyAbstract Objectives To verify whether propofol-assisted deep extubation is associated with fewer complications in pediatric patients undergoing dental treatment. Materials and methods This prospective study enrolled 60 pediatric candidates undergoing elective dental interventions, with randomized allocation to either deep extubation (DE; n = 30) or awake extubation (AE; n = 30) protocols. The primary endpoint was the incidence of at least 1 respiratory adverse event, whereas time to extubation (TOE), time to wake-up (TOW), hemodynamic fluctuations during extubation, incidence of emergence agitation (EA), nasal obstruction, epistaxis, sore throat, and hoarse voice after extubation were the secondary endpoints. Results The DE group reported significantly lower incidence of at least 1 respiratory adverse event (0.0% VS 23.3%, P = 0.016). The TOE was significantly shorter in the DE group, averaging 2.78 ± 0.87 min, compared to 5.50 ± 1.01 min in the AE group (P < .001). The TOW was longer in the DE group, with an average of 15.03 ± 3.44 min compared to 10.63 ± 1.52 min in the AE group (P < .001). The average value of mean arterial pressure (AVMAP) during extubation was lower in the DE group at 74.70 ± 13.35 mmHg, compared to 87.43 ± 15.31 mmHg in the AE group (P < .001). The average value of heart rate (AVHR) in the DE group was 108.37 ± 13.41 bpm, while in the AE group, it was 127.93 ± 20.74 bpm (P < .001). Additionally, the rates of sore throat and hoarse voice were significantly lower in the DE group (6.7% and 3.3%) than in the AE group (27% and 30%). Conclusions For pediatric patients undergoing dental treatment, propofol-assisted deep extubation is superior, allowing for less extubation time without increasing airway complications. This technique provides a smoother extubation with fewer hemodynamic fluctuations and lower incidences of voice hoarseness and persistent coughing, provided that certain rules for deep extubation are followed.https://doi.org/10.1186/s12871-025-03170-3Deep extubationMouth rehabilitationGeneral anesthesia
spellingShingle Wei Cui
Xiang Zhang
Ying Shang
Yun Liu
Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial
BMC Anesthesiology
Deep extubation
Mouth rehabilitation
General anesthesia
title Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial
title_full Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial
title_fullStr Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial
title_full_unstemmed Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial
title_short Propofol-assisted deep extubation in the dental treatment of pediatrics: a randomized controlled triple-blind trial
title_sort propofol assisted deep extubation in the dental treatment of pediatrics a randomized controlled triple blind trial
topic Deep extubation
Mouth rehabilitation
General anesthesia
url https://doi.org/10.1186/s12871-025-03170-3
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