Continuous positive airway pressure improves the immediate post-extubation airway patency / 대한마취과학회지

ABSTRACT

BACKGROUND: Endotracheal tube extubation can cause laryngospasm, aspiration, upper airway obstruction and hypoxia. In addition, the risk of pulmonary complication increases during extubation for the patients with a difficult airway or a cervical spine injury. The aim of this study was to exam the effect of continuous positive airway pressure (CPAP) on the post-extubation airway patency and the recovery from anesthesia at the recovery room. METHODS: 30 adult patients who were scheduled for spine surgery were randomly allocated into 2 groups depending on the using of CPAP before extubation. Neuromuscular monitoring was performed via accelomyography. Tracheal extubation was performed at a TOF ratio of 70%. The incidence of spontaneous recovery of respiration, without airway manipulation and hypoxia, at the recovery room was measured for each group. The time to get a PAR score of 10 at the recovery room and the discharge time from the recovery room were checked too. RESULTS: The incidence of spontaneous recovery of respiration without airway manipulation was 67% in the CPAP group, which was significantly greater than that of the control group (13%). Yet there was no difference between the CPAP and control groups for the incidence of hypoxia in the recovery room (13% and 20%, respectively). There were also no differences in the time to get a PAR score of 10 at the recovery room and the discharge time from the recovery room. CONCLUSIONS: CPAP that is applied for tracheal tube extubation improves the immediate post-extubation airway patency, but it does not reduce the recovery room pulmonary complications and the recovery room discharge time.