Incidence Of Airway Complications Associated With Deep Versus Awake Tracheal Extubation After Cholecystectomy In Adults

Abstract

The study conducted by medical students to compare airway complications arising from two extubation methods deep and awake following cholecystectomy at AIMS MZD.This experimental study was carried out at AIMS MZD from May 2024 to October 2024.Conducted as a randomized controlled trial with a sample of 60 adult patients aged between 20 and 50, the research examines the complications and recovery profiles linked to each extubation approach. Deep extubation involves removing the endotracheal tube while the patient remains under anesthesia, minimizing airway reflexes and potentially reducing immediate reactions like coughing. However, this technique poses a higher risk of complications, including respiratory depression, laryngospasm, and aspiration. Awake extubation, conversely, is performed once patients regain consciousness, allowing for active airway reflexes, which tend to mitigate the risk of severe respiratory events but may cause transient discomfort, such as coughing or hypertension. Key metrics such as the Richmond Agitation-Sedation Scale (RASS) and the Aldrete Scoring System are employed to assess patient recovery. Findings indicate that patients undergoing awake extubation had quicker recovery times, higher Aldrete scores, and more stable vital signs post-procedure compared to those extubated deeply. Statistical analysis and including chi-square testing, highlights a significant difference between the two techniques, with deep extubation leading to a greater frequency of postoperative complications and a prolonged stay in the recovery room. This study supports awake extubation as a preferred practice in most cases due to its association with fewer complications and faster recovery, although deep extubation may be beneficial in certain cases where minimizing immediate airway stimulation is critical. By aligning with existing literature and addressing limitations such as the single-center study design,

the research contributes valuable insights for anesthesiologists aiming to optimize extubation practices based on patient-specific needs and surgical contexts.