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Airway management in children during resection of the tonsils


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Materials and Methods: We conducted a comparative evaluation of anesthesia used during tracheal intubation with and without the application of muscle relaxants in cases of adenotonsillectomy in children. Intubation parameters were evaluated according to Cormack-Lehane scale; the presence of cough reflex, limb movement, laryngospasm and desaturation during intubation was also taken into account. The presence of cough, husky voice, and complaints ofpain in the throat were recorded in the monitoring report after extubation. We used the MOPS scale to evaluate postoperative pain and discomfort in children. Results: Tracheal intubation in children with adenotonsillectomy without the use of muscle relaxants was successful in 100% of the cases, despite the fact that, according to the Cormack-Lehane classification, first degree of visualization of the glottis during direct laryngoscopy was observed in 79.3% of the cases and the second degree was observed in 20.7% of the cases. No significant reactions in the cardiovascular system to the endotracheal tube were noted. The group without the use of muscle relaxants (p < 0.05) experienced earlier extubation and a shorter duration of anesthesia, which in turn contributed to a more rapid activation of the patients. According to the number of post-intubation complications, no significant differences in the two groups were observed. According to the MOPS scale, higher scores (p <0.05), indicating discomfort in the early postoperative (within the first 15 minutes after the operation) period were observed in the group with the use of muscle relaxants. Conclusions: Thus, the method of tracheal intubation without the use of muscle relaxants can be used for adenotonsillectomy in children.

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