Abstract
Background: Postoperative respiratory adverse
events are the most common perioperative complications in pediatric
anesthesia, particularly prevalent in children undergoing
tonsillectomy and adenoidectomy, with an incidence rate as high as
50%. The choice of anesthetic induction regimen directly influences
the incidence of respiratory adverse events during the induction
period. However, this effect seems to have minimal impact on
postoperative outcomes. The occurrence rate of postoperative
respiratory adverse events is likely more closely associated with
the anesthetic maintenance phase, yet this relationship remains
uncertain at present.
Methods: The objective of this study was
to assess the impact of different anesthetic maintenance regimens
on postoperative respiratory adverse events in pediatric patients
undergoing tonsillectomy and adenoidectomy. The AmPRAEC study is a
multicenter, randomized, double-blind controlled trial. A total of
717 pediatric patients were recruited from 12 medical centers and
randomly assigned to three groups: Group A (Intravenous Maintenance
Group, receiving propofol infusion); Group B
(Intravenous-Inhalational Combination Group, maintained with 1%
sevoflurane combined with propofol); and Group C (Inhalational
Maintenance Group, maintained with 2-3% sevoflurane inhalation).
The primary outcome measure was the incidence rate of postoperative
respiratory adverse events.
Discussion:This clinical trial aims to
elucidate the impact of various anesthetic maintenance regimens on
postoperative respiratory adverse events in pediatric patients. The
outcomes of this study are anticipated to facilitate
anesthesiologists in devising more comprehensive perioperative
management strategies, enhancing the comfort and improving the
clinical outcomes for this patient population.
Trial registration: The study protocol
was registered at Chinese Clinical Trial Registry
(http://www.chictr.org.cn) with registration number:
ChiCTR2300074803 on August 16, 2023.