Abstract: PURPOSE: To explore the differences in stress response and safety of nasotracheal extubation in different positions under light sedation after orthognathic surgery and to provide a reference for the selection of extubation position after orthognathic surgery. METHODS: According to the extubation position, patients under general anesthesia from Jan.2022 to Dec. 2022 were divided into supine position group(n=115) and lateral position group (n=115) following the orthognathic surgery. The stress response indexes including SBP, DBP and HR of the two groups were monitored and compared at 5 min before extubation (T0), 1 min before extubation(T1), 1 min after extubation (T2), and 5 min after extubation (T3). The incidence of oral bleeding, hoarseness, sore throat, laryngeal spasm, cough, agitation and retroglossal falling were compared between the two groups as the safety indexes of extubation. SPSS 26.0 software package was used for data analysis. RESULTS: Different time points, SBP, DBP and HR were significantly higher in the lateral group than that in the supine group at T1(P<0.05). SBP, DBP and HR were significantly lower in the lateral group than that in the supine group at T2 and T3(P<0.05). The incidence of retroglossal falling and cough in the lateral group were significantly lower than that in the supine group(P<0.05). There was no significant difference in the incidence of nasal bleeding, oral bleeding, hoarseness, wheezing, laryngospasm and agitation, between the two groups(P>0.05). CONCLUSIONS: It is more conductive to reduce stress response and improve the extubation safety under light sedation in lateral position than in supine position after orthognathic surgery.

Key words: Orthognathic surgery, Tracheal extubation, Body position, Stress response, Safety