Postoperative tracheal extubation- The sequelae

Authors : Manasa Dhananjaya, Nalini Kotekar, Apoorva Gupta, Nagaraja P S

DOI : 10.18231/j.ijca.2020.078

Volume : 7

Issue : 3

Year : 2020

Page No : 425-431

Aim: The frequency of problems related to tracheal extubation probably exceeds those related to tracheal
intubation. Our study was undertaken to determine the post extubation sequelae and haemodynamic
responses during tracheal extubation.
Material and Methods: The study group consisted of randomly selected 250 adult patients in the
age group of 18-65 years, belonging to ASA Grade I, II, III, posted for elective surgery under general
anaesthesia. We observed the following; Haemodynamic changes [Heart rate (HR), Mean arterial pressure
(MAP) changes] and immediate problems associated with post operative tracheal extubation such as
bucking, breath holding, cough, airway obstruction, stridor, sorethroat, vomiting, aspiration, pulmonary
oedema, residual paralysis occurring during the first 30 minutes of extubation.
Results: The changes in HR and MAP were significant soon after extubation (p<0> baseline value at 10th min (p=0.074) whereas MAP continued to be significant(p=0.032) even at 30th min.
Incidence of immediate problems associated with postoperative tracheal extubation was 38.4% and these
were: Bucking – 26.8%, Breath holding – 4.8%, Persistent cough – 4%, Airway obstruction – 2.4%, Stridor
– 0.4%, Sorethroat – 4%, Vomiting – 2.4%. There was no incidence of pulmonary aspiration, pulmonary
oedema, residual paralysis.
Conclusion: It is concluded that tracheal extubation causes haemodynamic instability and can be associated
with detrimental responses.

Keywords: Haemodynamic changes, Post operative complications, Tracheal Extubation.


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