BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practi...BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.展开更多
BACKGROUND:Pulmonary aspiration of gastric contents during tracheal intubation is a lifethreatening complication in emergency patients.Rapid sequence intubation is commonly performed to prevent aspiration but is not a...BACKGROUND:Pulmonary aspiration of gastric contents during tracheal intubation is a lifethreatening complication in emergency patients.Rapid sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related complications.Although it has been considered that aspiration can be prevented in the lateral position,few studies have evaluated the ability to prevent aspiration.Moreover,this position is not always a favorable position for tracheal intubation.If aspiration can be prevented in a clinically relevant semi-lateral position,it may be advantageous.We assessed the ability to prevent aspiration in the lateral position and various degrees of the semi-lateral position using a vomiting-regurgitation manikin model.METHODS:A manikin's head was placed in the neutral,simple extension,or sniffing position.The amount of aspirated saline into the bronchi during simulated vomiting was measured at semilateral position angles of 0°to 90° in 10° increments.The difference in the vertical height between the mouth corner and the inferior border of the vocal cord was measured radiologically at each semilateral position in the three head-neck positions.RESULTS:Pulmonary aspiration was prevented at the ≥70°,≥80°,and 90° semi-lateral positions in the neutral,simple extension,and sniffing positions,respectively.The mouth was lower than the vocal cord in the semi-lateral position in which aspiration was prevented.CONCLUSION:The lateral or excessive semi-lateral position was necessary to protect the lung from aspiration in the head-neck positions commonly used for tracheal intubation.Prevention of aspiration was difficult within clinically relevant semi-lateral positions.展开更多
BACKGROUND Massive esophageal variceal bleeding can be catastrophic,leading to high morbidity and mortality.Patients experiencing massive esophageal variceal bleeding are at high risk of aspiration and hemorrhagic sho...BACKGROUND Massive esophageal variceal bleeding can be catastrophic,leading to high morbidity and mortality.Patients experiencing massive esophageal variceal bleeding are at high risk of aspiration and hemorrhagic shock in acute episodes.Intubation and bleeding control are the two essential steps for resuscitation of these patients.CASE SUMMARY A 47-year-old male patient was admitted to our hospital with upper digestive tract bleeding.He was diagnosed with alcohol-induced liver cirrhosis and consequent esophagogastric varices.As he did not show a good response to somatostatin and Sengstaken-Blakemore tube placement,the patient was scheduled for endoscopic angiotherapy under anesthesia.Preoperative assessment showed an ASA physical status of III and Child-Pugh classification B.However,massive hemorrhage occurred just after induction of anesthesia.Intubation by video-guided laryngoscopy in the lateral decubitus position was attempted twice and was successful.After that,an experienced endoscopic ultrasound(EUS)specialist performed angiotherapy and occluded the culprit vessel.An ultra-thin gastroscope was then inserted into the endotracheal tube to extract the blood observed in the lobar bronchi.The patient suffered hemorrhagic shock with an estimated blood loss of 1500 mL in 20 min and remained in the intensive care unit for two days.The patient was discharged from our hospital eight days later without major complications.CONCLUSION Intubation in the lateral decubitus position and EUS-guided treatment can be lifesaving procedures in patients with massive upper gastrointestinal hemorrhage.展开更多
Previously, we reported the efficacy of a newly developed inverted overtube in shortening the hemostatic time and obtaining a clear endoscopic view in emergency endoscopic hemostasis. This device also helped us to per...Previously, we reported the efficacy of a newly developed inverted overtube in shortening the hemostatic time and obtaining a clear endoscopic view in emergency endoscopic hemostasis. This device also helped us to perform gastric endoscopic submucosal dissection(ESD) more safely by changing the direction of gravity in the right lateral position. To perform a safe ESD, it is important to make an appropriate angle and distance between the electric knife and the gastric mucosa. In this position, the distance to gastric mucosa is reduced, and the angle of the electric knife changes from vertical to somewhat oblique, facilitating safer cutting.展开更多
Young children undergoing MRI and CT investigations often require sedation or general anaesthesia,because they need to remain still during the procedures.Unfortunately,sedation can be associated with complications.The...Young children undergoing MRI and CT investigations often require sedation or general anaesthesia,because they need to remain still during the procedures.Unfortunately,sedation can be associated with complications.The very recently published study by Li and colleagues entitled“Impact of lateral positioning on upper airway morphol-ogy in sedated children under fve”suggests that putting the child in the lateral position may reduce these complications[1].It is an interesting fnding that needs to be explored further.展开更多
Background The upper airway morphology in children varies with age and body position.This study aimed to analyze the impact of lateral positioning on the upper airway of sedated children under fve.Methods This retrosp...Background The upper airway morphology in children varies with age and body position.This study aimed to analyze the impact of lateral positioning on the upper airway of sedated children under fve.Methods This retrospective study included pediatric patients who underwent MRI in both the supine and lateral positions at Children’s Hospital,Zhejiang University School of Medicine.Upper airway morphology was reconstructed using 3D Slicer software.Python was employed to estimate cross-sectional areas via pixel analysis.The narrowest cross-sectional area,minimal transverse and anteroposterior diameters,airway length,and airway volume were measured and stratifed by age for subgroup analysis.Results In sedated children under 5 years old and when compared to the supine position,lateral positioning increased minimal transverse diameter by 18.70%(P=0.001),narrowest cross-sectional area by 49.21%(P<0.001),anteroposterior diameter by 25.54%(P<0.001),airway volume by 65.64%(P<0.001),and airway length by 11.93%(P<0.001).In all subgroups,lateral positioning signifcantly increased the narrowest cross-sectional area,airway length,and airway volume.However,minimal anteroposterior diameter in the 1-to 3-year age group and minimal transverse diameter in the 3-to 5-year age group tended to increase in the lateral position but did not reach statistical signifcance.Conclusions Lateral position signifcantly enlarges the upper airway in sedated children under fve.These fndings support using lateral position to enhance airway patency in younger patients.展开更多
Introduction:Awake fiberoptic bronchoscopy has long been considered the criterion standard for the management of difficult airways because of large thyroid malignancies.After an unsuccessful attempt to intubate with a...Introduction:Awake fiberoptic bronchoscopy has long been considered the criterion standard for the management of difficult airways because of large thyroid malignancies.After an unsuccessful attempt to intubate with a fiberoptic bronchoscope in the supine position,the decision to switch to the left lateral position was made.We present this case to propose the utilization of the lateral position for awake intubation.Case presentation:We report a rare case of a patient with a large papillary carcinoma of the thyroid planned for surgical excision.The patient presented to our hospital with complaints of difficulty breathing while lying down in the supine position and oozing blood from the necrotic tissue.The breathing difficulties subsided in the lateral position.Conclusion:We demonstrated how the left lateral position with an adjunct maneuver facilitates intubation in large thyroid malignancies.展开更多
The skid resistance and pavement texture can vary a lot for different lane paths,meaning that the lateral shift of the vehicle driving in the lane section can affect the safety significantly.On the other hand,a varyin...The skid resistance and pavement texture can vary a lot for different lane paths,meaning that the lateral shift of the vehicle driving in the lane section can affect the safety significantly.On the other hand,a varying skid resistance across a lane section provides the opportunity to influence vehicles to run in lateral positions where the tire/road friction has not yet been reduced by wear;thus,improving safety.This measure would be useful only if the distribution of skid resistance and pavement texture in the lane sections are investigated at frequent intervals.This study focused on four test sections on in-service urban roads.A friction measuring device known as the T2GO system was used to test the skid resistance performance of pavements for both dry and wet conditions.A high-precision 3D-scanner was used to capture the pavement macrotexture,and a microscope was employed to investigate the pavement abrasion.Subsequently,the effect of the lateral variation across the lane of friction and texture was discussed.The feasibility of displacing the vehicles to run in tracks with better skid resistance was explored in terms of the measured friction and the texturedependent drainage capacity.The results indicated that driving closer to the lanes'right side means that better values of friction,texture,and drainage parameters of the unworn pavement surface can be utilized.A 0.3 m or more lateral displacement would create improved friction,in a range between 13%and 14%for 1.5 m track width and between 8%and 11%for 1.65 m track width.Furthermore,the results are useful in studying the vehicles'sideslip.展开更多
BACKGROUND:Atrial fibrilation(AF) is the most common complication following heart surgeries;it often occurs in patients after coronary artery bypass graft(CABG).The purpose of this review is to categorize prophylaxes ...BACKGROUND:Atrial fibrilation(AF) is the most common complication following heart surgeries;it often occurs in patients after coronary artery bypass graft(CABG).The purpose of this review is to categorize prophylaxes or treatment by administration of Amiodaron in patients with CABG.DATA RESOURCES:We searched google scholar,pubmed,and Cochrane Library databases(the period 1970-2010) for articles on Amiodaron in CABG and cardiac surgery.A total of 1 561 articles were identified,and 30 articles met the criteria and were enrolled in this review.RESULTS:Most studies supported Amiodarone for prophylaxi purpose in patients who were performed with CABG;few papers supported Amiodaron as a drug for treating CABG.The prophylaxis can decrease the incidence rate of AF in CABG,but if it uses as a treatment,the side effect of Amiodaron will decrease because all of the patients will not get Amiodarone.In the other hand use of Amiodarone as a treatment does not influence the length of hospital stay significantly but these kinds of study are so few.CONCLUSION:No appropriate therapeutic method has been defined for AF.At present,the common way of treating AF following cardiac surgery is mainly based on prophylaxis in medical books and references.展开更多
<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guid...<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guidance for clinical application. <b>Methods:</b> Seventy-two children who received oral treatment under general anesthesia from November 2020 to November 2021 in Yantai Stomatological Hospital were randomly divided into three groups, 24 cases in each group. All three groups of children entered the PACU after the surgery. The children in Group I were extubated in the supine position, the children in Group II were immediately changed to the right decubitus after extubation in the horizontal position, and the children in Group III were extubated in the right decubitus. HR, MAP and SpO<sub>2</sub> of T1 (the time point at the beginning of surgery), T2 (the time point at 1 hour after surgery), T3 (the time point after extubation), T4 (the time point at 1 minute after extubation), T5 (the time point at 3 minutes after extubation) in the three groups were observed, t1 (operation time) and t2 (the time of leaving the PACU) were recorded. The airway pressure (P1) in the recumbent position and the airway pressure (P2) in the right decubitus position before extubation were recorded in Group III. The number of sputum suction and complications after extubation were counted. <b>Results:</b> The t2 in Group III was shorter than that in Groups I and II, and the number of sputum suction in Group III was less than that in Groups I and II (P < 0.05). The HR at T3, T4 and T5 in Group III was lower than that in Group I, and the HR at T4 and T5 was lower than that in Group II (P < 0.05). There were significant differences in the incidence of respiratory complications among the three groups (P < 0.05). The incidence of asphyxia, bucking and glossocoma postoperative agitation in Group III was significantly lower than that in Group I, and the incidence of asphyxia and choking was lower than that in Group II (P < 0.05). The incidence of glossoptosis in Group II was significantly lower than that in Group I (P < 0.05). In Group III, the airway pressure P2 in the right decubitus position during endotracheal intubation was higher than that of P1 in the supine position during endotracheal intubation (P < 0.05). The 95% Confidence Interval (CI) of airway pressure difference was 1.416 - 1.834 cmH<sub>2</sub>O. <b>Conclusion:</b> For children undergoing intraoral therapy under general anesthesia, tracheal extubation in the right decubitus position can improve the circulation fluctuation before and after extubation, reducing the number of sputum suction and respiratory tract-related complications, and can shorten the departure time. The body position change during the tracheal intubation will slightly increase the airway pressure, but the supine position after extubation can better ensure the smooth spontaneous breathing of children, which can provide the reference for clinical application.展开更多
基金National Natural Science Foundation of China(U24A20714 to XMF and 82102238 to PC)。
文摘BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.
文摘BACKGROUND:Pulmonary aspiration of gastric contents during tracheal intubation is a lifethreatening complication in emergency patients.Rapid sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related complications.Although it has been considered that aspiration can be prevented in the lateral position,few studies have evaluated the ability to prevent aspiration.Moreover,this position is not always a favorable position for tracheal intubation.If aspiration can be prevented in a clinically relevant semi-lateral position,it may be advantageous.We assessed the ability to prevent aspiration in the lateral position and various degrees of the semi-lateral position using a vomiting-regurgitation manikin model.METHODS:A manikin's head was placed in the neutral,simple extension,or sniffing position.The amount of aspirated saline into the bronchi during simulated vomiting was measured at semilateral position angles of 0°to 90° in 10° increments.The difference in the vertical height between the mouth corner and the inferior border of the vocal cord was measured radiologically at each semilateral position in the three head-neck positions.RESULTS:Pulmonary aspiration was prevented at the ≥70°,≥80°,and 90° semi-lateral positions in the neutral,simple extension,and sniffing positions,respectively.The mouth was lower than the vocal cord in the semi-lateral position in which aspiration was prevented.CONCLUSION:The lateral or excessive semi-lateral position was necessary to protect the lung from aspiration in the head-neck positions commonly used for tracheal intubation.Prevention of aspiration was difficult within clinically relevant semi-lateral positions.
基金National Natural Science Foundation of China to CBL,No.81971876National Key Research and Development Program of China to FXM,No.2018YFC2001900.
文摘BACKGROUND Massive esophageal variceal bleeding can be catastrophic,leading to high morbidity and mortality.Patients experiencing massive esophageal variceal bleeding are at high risk of aspiration and hemorrhagic shock in acute episodes.Intubation and bleeding control are the two essential steps for resuscitation of these patients.CASE SUMMARY A 47-year-old male patient was admitted to our hospital with upper digestive tract bleeding.He was diagnosed with alcohol-induced liver cirrhosis and consequent esophagogastric varices.As he did not show a good response to somatostatin and Sengstaken-Blakemore tube placement,the patient was scheduled for endoscopic angiotherapy under anesthesia.Preoperative assessment showed an ASA physical status of III and Child-Pugh classification B.However,massive hemorrhage occurred just after induction of anesthesia.Intubation by video-guided laryngoscopy in the lateral decubitus position was attempted twice and was successful.After that,an experienced endoscopic ultrasound(EUS)specialist performed angiotherapy and occluded the culprit vessel.An ultra-thin gastroscope was then inserted into the endotracheal tube to extract the blood observed in the lobar bronchi.The patient suffered hemorrhagic shock with an estimated blood loss of 1500 mL in 20 min and remained in the intensive care unit for two days.The patient was discharged from our hospital eight days later without major complications.CONCLUSION Intubation in the lateral decubitus position and EUS-guided treatment can be lifesaving procedures in patients with massive upper gastrointestinal hemorrhage.
文摘Previously, we reported the efficacy of a newly developed inverted overtube in shortening the hemostatic time and obtaining a clear endoscopic view in emergency endoscopic hemostasis. This device also helped us to perform gastric endoscopic submucosal dissection(ESD) more safely by changing the direction of gravity in the right lateral position. To perform a safe ESD, it is important to make an appropriate angle and distance between the electric knife and the gastric mucosa. In this position, the distance to gastric mucosa is reduced, and the angle of the electric knife changes from vertical to somewhat oblique, facilitating safer cutting.
文摘Young children undergoing MRI and CT investigations often require sedation or general anaesthesia,because they need to remain still during the procedures.Unfortunately,sedation can be associated with complications.The very recently published study by Li and colleagues entitled“Impact of lateral positioning on upper airway morphol-ogy in sedated children under fve”suggests that putting the child in the lateral position may reduce these complications[1].It is an interesting fnding that needs to be explored further.
基金supported by the Key Research and Development Program of Zhejiang(2022C03163 to X.F.)the National Natural Science Foundation of China(82372184 to H.L.and 82302425 to H.Y.).
文摘Background The upper airway morphology in children varies with age and body position.This study aimed to analyze the impact of lateral positioning on the upper airway of sedated children under fve.Methods This retrospective study included pediatric patients who underwent MRI in both the supine and lateral positions at Children’s Hospital,Zhejiang University School of Medicine.Upper airway morphology was reconstructed using 3D Slicer software.Python was employed to estimate cross-sectional areas via pixel analysis.The narrowest cross-sectional area,minimal transverse and anteroposterior diameters,airway length,and airway volume were measured and stratifed by age for subgroup analysis.Results In sedated children under 5 years old and when compared to the supine position,lateral positioning increased minimal transverse diameter by 18.70%(P=0.001),narrowest cross-sectional area by 49.21%(P<0.001),anteroposterior diameter by 25.54%(P<0.001),airway volume by 65.64%(P<0.001),and airway length by 11.93%(P<0.001).In all subgroups,lateral positioning signifcantly increased the narrowest cross-sectional area,airway length,and airway volume.However,minimal anteroposterior diameter in the 1-to 3-year age group and minimal transverse diameter in the 3-to 5-year age group tended to increase in the lateral position but did not reach statistical signifcance.Conclusions Lateral position signifcantly enlarges the upper airway in sedated children under fve.These fndings support using lateral position to enhance airway patency in younger patients.
文摘Introduction:Awake fiberoptic bronchoscopy has long been considered the criterion standard for the management of difficult airways because of large thyroid malignancies.After an unsuccessful attempt to intubate with a fiberoptic bronchoscope in the supine position,the decision to switch to the left lateral position was made.We present this case to propose the utilization of the lateral position for awake intubation.Case presentation:We report a rare case of a patient with a large papillary carcinoma of the thyroid planned for surgical excision.The patient presented to our hospital with complaints of difficulty breathing while lying down in the supine position and oozing blood from the necrotic tissue.The breathing difficulties subsided in the lateral position.Conclusion:We demonstrated how the left lateral position with an adjunct maneuver facilitates intubation in large thyroid malignancies.
基金supported by National Key R&D Program of China(No.2018YFB1600200)the Fundamental Research Funds for the Central Universities(Nos.310821173101,300102218515)。
文摘The skid resistance and pavement texture can vary a lot for different lane paths,meaning that the lateral shift of the vehicle driving in the lane section can affect the safety significantly.On the other hand,a varying skid resistance across a lane section provides the opportunity to influence vehicles to run in lateral positions where the tire/road friction has not yet been reduced by wear;thus,improving safety.This measure would be useful only if the distribution of skid resistance and pavement texture in the lane sections are investigated at frequent intervals.This study focused on four test sections on in-service urban roads.A friction measuring device known as the T2GO system was used to test the skid resistance performance of pavements for both dry and wet conditions.A high-precision 3D-scanner was used to capture the pavement macrotexture,and a microscope was employed to investigate the pavement abrasion.Subsequently,the effect of the lateral variation across the lane of friction and texture was discussed.The feasibility of displacing the vehicles to run in tracks with better skid resistance was explored in terms of the measured friction and the texturedependent drainage capacity.The results indicated that driving closer to the lanes'right side means that better values of friction,texture,and drainage parameters of the unworn pavement surface can be utilized.A 0.3 m or more lateral displacement would create improved friction,in a range between 13%and 14%for 1.5 m track width and between 8%and 11%for 1.65 m track width.Furthermore,the results are useful in studying the vehicles'sideslip.
文摘BACKGROUND:Atrial fibrilation(AF) is the most common complication following heart surgeries;it often occurs in patients after coronary artery bypass graft(CABG).The purpose of this review is to categorize prophylaxes or treatment by administration of Amiodaron in patients with CABG.DATA RESOURCES:We searched google scholar,pubmed,and Cochrane Library databases(the period 1970-2010) for articles on Amiodaron in CABG and cardiac surgery.A total of 1 561 articles were identified,and 30 articles met the criteria and were enrolled in this review.RESULTS:Most studies supported Amiodarone for prophylaxi purpose in patients who were performed with CABG;few papers supported Amiodaron as a drug for treating CABG.The prophylaxis can decrease the incidence rate of AF in CABG,but if it uses as a treatment,the side effect of Amiodaron will decrease because all of the patients will not get Amiodarone.In the other hand use of Amiodarone as a treatment does not influence the length of hospital stay significantly but these kinds of study are so few.CONCLUSION:No appropriate therapeutic method has been defined for AF.At present,the common way of treating AF following cardiac surgery is mainly based on prophylaxis in medical books and references.
文摘<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guidance for clinical application. <b>Methods:</b> Seventy-two children who received oral treatment under general anesthesia from November 2020 to November 2021 in Yantai Stomatological Hospital were randomly divided into three groups, 24 cases in each group. All three groups of children entered the PACU after the surgery. The children in Group I were extubated in the supine position, the children in Group II were immediately changed to the right decubitus after extubation in the horizontal position, and the children in Group III were extubated in the right decubitus. HR, MAP and SpO<sub>2</sub> of T1 (the time point at the beginning of surgery), T2 (the time point at 1 hour after surgery), T3 (the time point after extubation), T4 (the time point at 1 minute after extubation), T5 (the time point at 3 minutes after extubation) in the three groups were observed, t1 (operation time) and t2 (the time of leaving the PACU) were recorded. The airway pressure (P1) in the recumbent position and the airway pressure (P2) in the right decubitus position before extubation were recorded in Group III. The number of sputum suction and complications after extubation were counted. <b>Results:</b> The t2 in Group III was shorter than that in Groups I and II, and the number of sputum suction in Group III was less than that in Groups I and II (P < 0.05). The HR at T3, T4 and T5 in Group III was lower than that in Group I, and the HR at T4 and T5 was lower than that in Group II (P < 0.05). There were significant differences in the incidence of respiratory complications among the three groups (P < 0.05). The incidence of asphyxia, bucking and glossocoma postoperative agitation in Group III was significantly lower than that in Group I, and the incidence of asphyxia and choking was lower than that in Group II (P < 0.05). The incidence of glossoptosis in Group II was significantly lower than that in Group I (P < 0.05). In Group III, the airway pressure P2 in the right decubitus position during endotracheal intubation was higher than that of P1 in the supine position during endotracheal intubation (P < 0.05). The 95% Confidence Interval (CI) of airway pressure difference was 1.416 - 1.834 cmH<sub>2</sub>O. <b>Conclusion:</b> For children undergoing intraoral therapy under general anesthesia, tracheal extubation in the right decubitus position can improve the circulation fluctuation before and after extubation, reducing the number of sputum suction and respiratory tract-related complications, and can shorten the departure time. The body position change during the tracheal intubation will slightly increase the airway pressure, but the supine position after extubation can better ensure the smooth spontaneous breathing of children, which can provide the reference for clinical application.
