Effects of Different Inspiratory:Expiratory Ratios on Respiratory and Recovery Outcomes During Dental Procedures Under General Anesthesia in Pediatric Patients

NCT ID: NCT07323420

Last Updated: 2026-01-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

75 participants

Study Classification

OBSERVATIONAL

Study Start Date

2026-01-12

Study Completion Date

2026-12-30

Brief Summary

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This observational study aims to evaluate the effects of different inspiratory to expiratory (I:E) ratios (1:2 vs. 1:3) during mechanical ventilation in pediatric patients undergoing dental procedures under general anesthesia. Due to behavioral challenges, dental phobia, or medical conditions, general anesthesia is often required to ensure immobility and cooperation during dental treatments in children.

In the clinic where the study will be conducted, the I:E ratio is routinely adjusted approximately 20-30 minutes before the end of the procedure to facilitate a smoother transition to spontaneous breathing during emergence from anesthesia. While 1:2 is commonly used, the 1:3 ratio may improve respiratory efficiency and recovery by prolonging the expiratory phase.

The study aims to compare vital signs, respiratory parameters (heart rate, blood pressure, SpO₂, EtCO₂, respiratory rate), recovery quality, and respiratory complications between the two I:E ratios. The findings aim to optimize ventilation strategies and improve patient comfort and safety during emergence from anesthesia.

Detailed Description

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The recent study involves pediatric patients undergoing dental procedures under general anesthesia following routine and standard clinical protocols. No additional interventions beyond standard care will be applied.

Specifically for the study, a non-invasive, observational scoring system will be used during the emergence phase to assess respiratory quality without requiring any extra tests or procedures. The scoring includes observation of spontaneous breathing, accessory muscle use, airway patency, physical responses to painful stimuli, and coughing episodes.

Patients will receive the same anesthesia and dental treatment as those not included in the study. The study compares the effects of routine inspiratory:expiratory (I:E) ratios used during mechanical ventilation on respiratory and recovery outcomes.

Variables assessed include vital and respiratory parameters (heart rate, blood pressure, SpO₂, EtCO₂, respiratory rate, peak airway pressure, time to spontaneous breathing, and physical/hemodynamic responses during spontaneous breathing), respiratory quality post-extubation (evaluated via the study-specific scale), and recovery parameters (physical responses during airway suctioning/extubation, presence of bronchospasm/ laryngospasm, agitation levels measured preoperatively by Modified Yale Preoperative Anxiety Scale and postoperatively by the Pediatric Anesthesia Emergence Delirium Scale (PAED), Modified Aldrete score, and discharge times from recovery and hospital wards).

All data will be recorded in a patient tracking form prepared for the study. Induction, maintenance, emergence from anesthesia, and management of any complications will follow routine clinical practice without any changes. No modifications to anesthesia or dental treatment protocols will be required for the study.

Conditions

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Respiratory Function Pediatric Anesthesia General Anesthesia

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1: Control

Patients who emerge from anesthesia earlier than planned without pre-emergence preparation. A minimum of 15 patients will be enrolled in this group.

No interventions assigned to this group

Group 2: I:E 1:2

Patients undergoing standart dental procedures under general anesthesia; during the last phase of the procedure, mechanical ventilation will be applied with an I:E ratio of 1:2. A minimum of 30 patients will be enrolled in this group.

No interventions assigned to this group

Group 3: I:E 1:3

Patients undergoing standart dental procedures under general anesthesia; during the last phase of the procedure, mechanical ventilation will be applied with an I:E ratio of 1:3. A minimum of 30 patients will be enrolled in this group.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Pediatric patients scheduled for dental procedures under general anesthesia at our faculty.
* American Society of Anesthesiologists (ASA) Physical Status I or II.
* Age between 2 and 12 years.
* Written informed consent obtained from parents or legal guardians.

Exclusion Criteria

* Patients whose parents or legal guardians decline participation.
* Presence of adenoid hypertrophy \>30%.
* Macroglossia or retrognathia.
* Severe obesity or developmental delay.
* History of delayed emergence from anesthesia.
* ASA Physical Status III or higher.
* Anesthesia duration less than 1 hour or more than 3 hours.
* Patients with difficult airway management or ventilation.
* Known pulmonary or airway diseases or anomalies.
* Use of pharmacological agents that may affect spontaneous respiratory quality.
* Presence of neuromuscular disorders affecting respiratory function.
* Age \<2 years or \>12 years.
* Administration of medications intraoperatively or preoperatively that may influence respiratory dynamics during emergence (e.g., atropine, lidocaine, steroids).
Minimum Eligible Age

2 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Kırıkkale University

OTHER

Sponsor Role lead

Responsible Party

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Gözde Nur Erkan

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kırıkkale University, Faculty of Dentistry

Kırıkkale, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Gözde Nur Erkan Assisstant Professor

Role: CONTACT

+903182244927 ext. 7140

Facility Contacts

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Assisstant Professor Gözde Nur Erkan

Role: primary

+903182244927 ext. 7140

Other Identifiers

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KU-ERKAN-004

Identifier Type: -

Identifier Source: org_study_id

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