Tracheal extubation with suction vs. positive pressure during emergence from general anaesthesia in adults: A randomised controlled trial - 20/03/18
, Olivier Wira a, b, Chritel Castelli c, Jean-Emmanuel de La Coussaye a, b, Jacques Ripart a, b, Philippe Cuvillon a, bBienvenue sur EM-consulte, la référence des professionnels de santé.
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| Iconographies | 2 |
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Abstract |
Background |
After general anaesthesia (GA) in adults, the optimal tracheal extubation technique (positive pressure or suctioning) remains debated. The primary endpoint of this study was to assess the effects of these techniques on onset time of desaturation (SpO2<92%).
Methods |
Sixty-nine patients with a body mass index<30 scheduled for elective orthopaedic surgery were allocated to positive pressure (PP) or suctioning (SUC) group. GA was standardised with propofol and remifentanil via target-controlled infusion. A morphine bolus of 0.15mg/kg was administered 20–30mins before the end of surgery. The effect of extubation technique on onset time of desaturation (T92) was assessed during the first 10mins after extubation during the spontaneous air breathing. Secondary endpoints included: frequency of desaturation, respiratory complications, need to use oxygen therapy and SpO2 at the end of the first hour while breathing in air (ClinicalTrials.gov identifier: NCT01323049).
Results |
Baseline patient characteristics and intraoperative management data for the 68 patients included had no relevant clinical difference between groups. T92 (sec) after tracheal extubation was 214 (168) vs. 248 (148) in the PP and SUC groups, respectively (P=0.44). In the PP and SUC groups, 50 and 43% reached a SpO2<92% within the first 10mins after extubation respectively (P=0.73). There were no statistically significant differences between groups for any secondary endpoints.
Conclusions |
Positive pressure extubation as compared with suctioning extubation did not seem to delay onset time of desaturation after GA in standard weight adult patients.
Le texte complet de cet article est disponible en PDF.Keywords : Anaesthesia recovery period, Airway management, Airway extubation
Plan
| ☆ | Trial Registry Number: NCT01323049; 24 March 2011. |
| ☆☆ | Presentation: preliminary data for this study were presented as a poster presentation at the French Society of Anaesthesia and Intensive Care's Annual Congress, 17–19 September 2015, Paris. |
Vol 37 - N° 2
P. 147-153 - avril 2018 Retour au numéro
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