Factors affecting airway compliance and resistance in children receiving general anesthesia during adenotonsillectomy

Airway compliance is an important index in the surgery of pediatric patients. This study aimed to explore factors affecting dynamic airway compliance (Cdyn) and airway resistance (Raw) after general anesthesia endotracheal intubation for adenotonsillectomy of pediatric patients. A prospective study was undertaken of 107 children who underwent adenotonsillectomy in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine between January and June 2018. The values of Cdyn and Raw were recorded at 5, 10, and 15 minute during general anesthesia endotracheal intubation. Univariate analysis and multiple linear regression analysis were performed for factors that affected Cdyn and Raw. Of the 107 patients aged 56.67 ± 18.28 months, 69 (64%) patients were male, and 26 (24%) and 12 (11%) had an upper respiratory infection in the past week and 1 to 2 weeks, respectively. During anesthesia, Cdyn showed a decreasing trend (P < .001) while Raw showed an increasing trend (P < .001). Multivariate analysis revealed that height (β=0.177–0.193) had the strongest correlation with Cdyn; rales during pulmonary auscultation (β= –2.727 to –1.363) and sputum suction (β= –1.670 to –0.949) were also associated with Cdyn (all P < .05). Height was the factor with the strongest negative correlation with Raw (β= –0.382 to –0.305). Rales during pulmonary auscultation (β=10.063–11.326) and sputum suction (β=3.863–9.003) were also associated with Raw (All P < .05). Height, rales during preoperative auscultation and sputum suction were all associated with intraoperative Cydn and Raw for pediatric patients undergoing adenotonsillectomy and should be considered before the surgery.