An audit of airway problems in the recovery room

Abdy, Sharon

doi:10.1046/j.1365-2044.1999.00746.x

Cited by 20 publications

(5 citation statements)

References 12 publications

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“…Data from the UK suggest that respiratory complications are common at extubation and during recovery [7,8]. In the fourth National Audit Project (NAP4) of the Royal College of Anaesthetists and the DAS, major airway complications occurred during emergence or in recovery in approximately one third of the reported cases relating to anaesthesia [9].…”

mentioning

confidence: 99%

Difficult Airway Society Guidelines for the management of tracheal extubation

Mitchell¹,

Dravid²,

Patel³

et al. 2012

Anaesthesia

430

139

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SummaryTracheal extubation is a high‐risk phase of anaesthesia. The majority of problems that occur during extubation and emergence are of a minor nature, but a small and significant number may result in injury or death. The need for a strategy incorporating extubation is mentioned in several international airway management guidelines, but the subject is not discussed in detail, and the emphasis has been on extubation of the patient with a difficult airway. The Difficult Airway Society has developed guidelines for the safe management of tracheal extubation in adult peri‐operative practice. The guidelines discuss the problems arising during extubation and recovery and promote a strategic, stepwise approach to extubation. They emphasise the importance of planning and preparation, and include practical techniques for use in clinical practice and recommendations for post‐extubation care.

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mentioning

confidence: 99%

Difficult Airway Society Guidelines for the management of tracheal extubation

Mitchell¹,

Dravid²,

Patel³

et al. 2012

Anaesthesia

430

139

View full text Add to dashboard Cite

show abstract

“…9,11 The LMA, when properly inserted, provides a clear airway without desaturation, coughing, bucking or staining and with a minimal cardiovascular response that facilities a smooth return to consciousness. 12,13 The study was planned to find a novel method to achieve a smooth extubation in neurosurgery and compare the respiratory and hemodynamic responses and associated complications following conventional awake extubation of a ETT and that following exchange extubation of ETT using a LMA in neurosurgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of conventional awake extubation with endotracheal tube – laryngeal mask airway exchange extubation for evaluation of respiratory and hemodynamic parameters during emergence in neurosurgical patients

et al. 2022

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Background: Emergence from general anesthesia and tracheal extubation may be associated with tremendous physiological and metabolic stress in patients which could be major concern for the anesthesiologist in patients especially with neurosurgical patients. Aims and Objectives: The study was designed to find a novel method to achieving a smooth extubation in neurosurgery by compare the respiratory complications and hemodynamic stress response between conventional awake extubation of an endotracheal tube (ETT) and that following exchange extubation of ETT using a laryngeal mask airway (LMA) in craniotomy surgeries. Materials and Methods: A total of 60 patients of American Society of Anesthesiologists physical status I and II between ages 18 and 60 years undergoing neurosurgery were evaluated for respiratory events such as bucking, coughing, desaturation, and hemodynamic changes due to sympathetic stimulation such as tachycardia, hypertension, and any other complications that have occurred in any of the two extubation methods. Results: In Group A, 86.67% patients have shown significant events of bucking and coughing while desaturation events were comparable between two groups. Manipulation events, that is, chin lift and jaw thrust had to perform in 66.67% and 21.67%, respectively, in patients of Group A compared to only 03.33% patients in Group L. (P<0.05). In Group A, 97.33% patients shown tachycardia compared to 30% in Group L where only 30%. Similarly, mean arterial pressure after extubation found to be significantly high in 63.33% of the patients in Group A with 63.33% as compared to13.33% of patients in Group L (P<0.05). Conclusion: ETT/LMA exchange is the most effective technique for achieving the clinical endpoints of the study, that is, prevention of emergence hypertension and respiratory complications compared to awake extubation methods. The exchange of ETT with LMA in deeper plane of anesthesia significantly reduces emergence related the hemodynamic and respiratory unwonted events.

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“…Extubation can result in a significant number of problems with serious consequences, including hypoxic brain injury and death. [2] Extubation and emergence from general anaesthesia is a stressful event which is a less addressed clinical entity. Problems associated with extubation, recovery, and emergences are more common than problems at intubation.…”

Section: Introductionmentioning

confidence: 99%

The Sedation Score (Ramsay Sedation Score) and Recovery Profile (Modified Aldrete’s Score) in Fentanyl, Dexmedetomidineand Placebo Groups

Ali¹,

Tr²

2019

AAN

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Background: Extubation and emergence from general anesthesia is a stressful event which is a less addressed clinical entity. Problems associated with extubation, recovery, and emergences are more common than problems at intubation. Reports from the UK suggest that respiratory complications are common at extubation and during recovery. Death or brain injury was more common in claims associated with extubation and recovery than those occurring at the time of induction of anesthesia. Subjects and Methods: The Consolidated Standards of Reporting Trials (CONSORT) recommendations for reporting randomized, control clinical trials were followed. After obtaining hospital ethics committee approval, a prospective randomized controlled study was done to compare fentanyl, dexmedetomidine and placebo in attenuating of hemodynamic stress response during extubation and emergence from general anaesthesia; in 150 patients with 50 patients in each of 3 groups. Results: Sedation score at 15 min in group A was 1.64±0.56, in group B sedation score was 2.36±0.53. Among group A & B, there was statistically significant difference at 15, 20 and at 120 minutes following extubation (p<0.050). At remaining interval of observation there was no statistically significant difference (p>0.050). Recovery score at 15 min following extubation in group A, B, C were 13.28±0.50, 13.78±0.46, 13.78±0.42 respectively. Conclusion: There was statistically significant difference in recovery score among the groups (p<0.001) at 15, 20, 25 minutes of study period. But clinically recovery score were nearly similar in all 3 groups.

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An audit of airway problems in the recovery room

Cited by 20 publications

References 12 publications

Difficult Airway Society Guidelines for the management of tracheal extubation

Difficult Airway Society Guidelines for the management of tracheal extubation

Comparison of conventional awake extubation with endotracheal tube – laryngeal mask airway exchange extubation for evaluation of respiratory and hemodynamic parameters during emergence in neurosurgical patients

The Sedation Score (Ramsay Sedation Score) and Recovery Profile (Modified Aldrete’s Score) in Fentanyl, Dexmedetomidineand Placebo Groups

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