Survey of Postoperative Endotracheal Tube Extubation Practice

Kim, Joo Duk; Kim, Kyung Han

Abstract

BACKGROUND: There is a greater incidence of complications such as desaturation, laryngospasm, airway obstruction and vomiting during tracheal extubation than intubation. We survey to ascertain current tracheal extubation practice and to estimate the incidence of problems associated with extubation and suggest the recommendation about extubation practice.
METHODS
We sent an anonymous questionnaire to resident and staffs of anesthesiology departments in five different area. These anesthesiologists were asked to complete and return anonymously in the stamped, addressed envelope provided. We received 130 replies from 134 questionnaires (97%).
RESULTS
We found that 38% of respondents use awake extubation and only 1% use it for deep extubation. Eighty-two percent would use reversal agents at extubation. More than 75% usually extubated at the end of inspiration. The administration of 100% oxygen before extubation was 'always' used in every case by 81% of anesthesiologists. Many respondents are extubating elective, emergency surgery, and obese patients in the supine position regardless of patients situation and not following the traditional practice of extubating in the head-down and left lateral position. Every respondent had experienced average 4.1 extubation complications during last 3 months. The incidences of postoperative complications such as excessive coughing (15.3%), irritability (13.8%), desaturation (9.9%), airway obstruction (8.7%) were relatively high in our survey.
CONCLUSIONS
We should need to discuss and establish recommendation how they are trained in extubation on the basis of more surveys and reported experiences.