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

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.

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 \12 years. * Administration of medications intraoperatively or preoperatively that may influence respiratory dynamics during emergence (e.g., atropine, lidocaine, steroids).