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Randomized Controlled Trial
. 2025 Jul 1;25(1):300.
doi: 10.1186/s12871-025-03170-3.

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

Wei Cui #  1 , Xiang Zhang #  1   2 , Ying Shang  3 , Yun Liu  4
Affiliations
Randomized Controlled Trial

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

Wei Cui et al. BMC Anesthesiol. .

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.

Keywords: Deep extubation; General anesthesia; Mouth rehabilitation.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval for the present RCT was provided by the Ethics Committee of Baoding Second Hospital (no. KY2023044). The study was registered at www.chictr.org.cn (no. ChiCTR2400079951), and informed written consent was obtained from the legal guardians of all included participants before the study. All methods were performed in accordance with the relevant guidelines and regulations of the Helsinki Declaration. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A trial flowchart
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