Copyright © 2013 International Anesthesia Research Society DOI: 10.1213/ANE.0b013e31827ab572 It is increasingly recognized that extubation of the difficult airway is a situation at risk of life-threatening complications, whereas criteria and guidelines to guide safe practices in airway management at extubation are still based on limited scientific evidence and of unproven effectiveness in impro...

Background and Aims Cardiovascular stress response to extubation can result in elevated heart rate (HR) and mean arterial blood pressures which can be detrimental in high-risk patients. Settings and Design The objective of this study is to compare the esmolol and labetalol efficacy in attenuating hemodynamic response to tracheal extubation. Materials and Methods Sixty patients scheduled for...

Airway management relates to the period of tracheal intubation, maintenance of endotracheal tube in situ, and finally extubation. Problems related to difficult extubation still pose significant challenge for both anesthesiologists and intensivists. This article reviews current approach to extubation strategy following difficult intubation. Guidelines and algorithm may be helpful in order to ens...

BACKGROUND Residual paralysis associated with the use of long-acting muscle relaxants can delay recovery from anesthesia and surgery. The authors tested the hypothesis that use of shorter-acting neuromuscular blocking agents is associated with reductions in tracheal extubation times and intensive care unit (ICU) length of stay in patients undergoing cardiac surgery with cardiopulmonary bypass. ...

Background: Emergence from general anesthesia and removing of tracheal tube can be associated with coughing, agitation, and hemodynamic disturbances. Dexmedetomidine is an alpha two adrenoceptor agonist that has effective sedation with less cardiovascular unstability and respiratory depression and may be useful for extubation and prevention of hemodynamic response during tracheal tube removing....

Adverse events following surgical operations are common complications due to removal of tracheal tube in contrast to the tracheal intubation. Awareness about the new methods and strategies for tracheal tube extubation is necessary for a safe and successful extubation. Therefore, we aimed to assess the safety and efficacy of laryngeal mask airway (LMA), streamlined liner of the pharyngeal airway...

Negative-pressure pulmonary oedema caused by upper airway obstruction after tracheal extubation is well recognised, but extensive pulmonary haemorrhage is rare. We report a case of post-extubation, laryngospasm-induced pulmonary oedema with associated pulmonary haemorrhage. The patient required mechanical ventilation with high positive end-expiratory pressure.

Stridor is a serious complication of congenital neuraxial anomalies, which though, can get completely resolved with early neurosurgical correction of the anomaly. However, stridor relief may or may not be achieved soon after surgery. Persistent postoperative stridor can potentially cause extubation failure that may be difficult to handle in small children. There are no extubation guidelines for...