Baftiu Nehat, Krasniqi Islam, Haxhirexha Kastriot, Domi Rudin
Clinic for Anaesthesiology and Intensive Care, University Clinical Centre of Kosovo, Prishtina, Kosovo.
Open Access Maced J Med Sci. 2018 Feb 12;6(2):350-354. doi: 10.3889/oamjms.2018.083. eCollection 2018 Feb 15.
Tracheal extubations may be performed before or after awakening from anaesthesia. The advantage of extubation during anaesthesia may avoid all the unpleasant effects of fully awake extubation such as severe hypertension and tachycardia, malignant dysrhythmias, myocardial ischemia laryngospasm, and cough induced high intraocular and intracranial pressure.
To show the current practice of performing extubations in Kosovo, as well as the advantage and disadvantage in performing this procedure in an awake patient or inpatient in light anaesthesia.
This study is conducted at the Regional Hospitals and the University Clinical Center of Kosovo during the year 2015. A questionnaire is given to the anesthesiologists to collect information about the techniques used for extubation, timing and management of extubation.
Based on this survey results that 86% of an anesthesiologist (71) extubate the patients when they are completely awake, while 14% of them (12) prefer to extubate the patients under light anaesthesia. From all anesthesiologists involved in this study, forty of them reported problems during extubation. Complications were related to airway, and they are treated by oxygenation and jaw support, but in rare cases, reintubation were performed.
Complications during extubation remain important risk factor while extubation during light anaesthesia can minimise some of them.
气管拔管可在麻醉苏醒前或苏醒后进行。麻醉期间拔管的优点可能是避免完全清醒拔管的所有不良影响,如严重高血压和心动过速、恶性心律失常、心肌缺血、喉痉挛以及咳嗽引起的高眼压和颅内压。
展示科索沃目前进行气管拔管的做法,以及在清醒患者或浅麻醉住院患者中进行该操作的优缺点。
本研究于2015年在科索沃的地区医院和大学临床中心进行。向麻醉医生发放问卷,以收集有关拔管技术、拔管时机和管理的信息。
根据这项调查结果,86%的麻醉医生(71人)在患者完全清醒时进行拔管,而14%的麻醉医生(12人)更喜欢在浅麻醉下为患者拔管。参与本研究的所有麻醉医生中,有40人报告了拔管过程中出现的问题。并发症与气道有关,通过给氧和下颌支持进行处理,但在极少数情况下进行了重新插管。
拔管期间的并发症仍然是重要的危险因素,而浅麻醉下拔管可以将其中一些并发症降至最低。