Respiratory complications associated with tracheal intubation and extubation.
We conducted a prospective survey on the incidence of respiratory complications associated with tracheal intubation and extubation in 1005 patients who underwent elective general anaesthesia over a 4-month period. During induction of anaesthesia, respiratory complications occurred in 46 patients (4.6%; 95% confidence limits (CL): 3.3, 5.9%). The common complications were coughing (1.5%) and difficult ventilation through a facemask (1.4%). Tracheal intubation was difficult in eight patients (0.8%). Complications occurred immediately after tracheal extubation in 127 patients (12.6%; 95% CL: 10.6, 14.7) and in the recovery room in 95 patients (9.5%; 95% CL: 7.6, 11.3%). The common complications immediately after extubation were coughing (6.6%) and oxygen desaturation (SaO2 < 90%) (2.4%), and in the recovery room, airway obstruction (3.8%) and coughing (3.1%). The incidence of complications was significantly higher immediately after tracheal extubation than during induction of anaesthesia (P << 0.001). Even when all incidents of coughing that occurred after tracheal extubation were disregarded as a complication, the overall incidence was still higher immediately after extubation (7.4%) than during induction of anaesthesia (P < 0.01). We conclude that the incidence of respiratory complications associated with tracheal extubation may be higher than that during tracheal intubation.
Department of Anaesthetics and Intensive Care Medicine, University Hospital of Wales, Cardiff.
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Vaughan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007828:Laryngoscopy; D008297:Male; D008397:Masks; D008875:Middle Aged; D011446:Prospective Studies; D012120:Respiration Disorders / Q000209:etiology*; D012121:Respiration, Artificial; D012307:Risk Factors