Laryngospasm and postoperative nausea and vomiting (PONV) are serious complications after surgery in pediatric anesthesia and may lead to some morbidity like pulmonary aspiration.
The objective of this randomized, single-blind, single-center study is to compare the incidence of laryngospasm and PONV in children undergoing general anesthesia with two methods of ventilation, control ventilation or spontaneous respiration. Two hundreds children aged 2-7 years who underwent inguinal or femoral hernia surgery will randomly (according to random number table) participate in this study. The patients will be unaware of the type of interventions. The patients with history of asthma; Fever; Morbid obesity; Cardiac disease; Metabolic disease; Renal disease; Electrolyte imbalance; and SpO2 under %85 will not be included in this study. Exclusion criteria: respiratory complication in the time of intubation.
Anesthesia will be induced with fentanyl 1microg/Kg, and thiopentone 4mg/Kg in all patients. In control ventilation group, atracurium will be injected as muscle relaxant before intubation. After intubation , the tidal volume will be set as 8-10 ml/kg and respiratory rate between 14-16 rate/minute. In spontaneous respiration (SR) group, after increasing the dose of halothane (1-4%), when the optimal depth of anesthesia will be established, the patients will be intubated, and the anesthetic gas will be delivered to patients by a Mapelson system. In the time of surgery, halothane 1- 2% in N2O/O2 will be delivered to all patients as anesthetic agents. At the end of surgery, the muscle relaxant will be antagonized with neostigmine 50 microgram per kilogram-atropine 25 microgram per kilogram in control ventilation group, but these drugs will not be needed in patients in spontaneous respiration group. The incidence of post operative, nausea, vomiting, laryngospasm in two groups will be compared.