Effect of the time to extubate in children with adenotonsillectomy on recovery of anaesthesia and postoperative cognitive dysfunction

Objective To investigate the effect of the time to extubate in children with adenotonsillectomy on recovery of anaesthesia and postoperative cognitive dysfunction under Narcotrend monitoring. Methods 76 children who recieved low temperature plasma adenotonsillectomy in Shaoguan Maternal and Child Health Care Hospital from January 2019 to September 2020 were selected.According to the Narcotrend(NT) value during extubation, they were divided into three groups: group A NT maintained at 95-100with 23 cases, group B(NT maintained at 80-94) with 25 cases and group C(NT maintained at 65-79) with 28 cases. The differences in CHIPPS scores, anesthesia recovery time, and the incidence of respiratory depression and retrolingual drop, etc.between the three groups were compared. The MMSE scale and MoCA scale were used to evaluate the cognitive function of the patients on preoperative 1 day, postoperative 1 day, postoperative 3 day and postoperative 7 day. Results Anesthesia recovery time in group C was significantly higher than that in group A and group B, the CHIPPS scores in group A were significantly higher than those in group B and group C, and the incidence of adverse reactions(ADRs) to extubation in group A and group C was significantly higher than that in group B, with statistically significant differences(P< 0. 05). There were differences in MMSE and MoCA scores among the three groups. On the 1 st and 3 rd days after operation, the MMSE and MoCA scores in group B were significantly higher than those in group A and group C(P< 0. 05). Conclusion Maintaining the NT value between 80 and 94 after operation can reduce the ADRs and cognitive impairment in the process of tracheal catheter extubation after adenotonsillectomy.