Immediate Respiratory Complications after Tracheal Extubation at the End of Elective Surgeries in an Academic Based Hospital in Iran: A Preliminary Survey

Postoperative complications and patient safety are of great importance to every anesthesiologist. These complications are even more important when related to the respiratory or cardiovascular system.  The present study aimed to evaluate the frequency of major and minor respiratory complications that occur after tracheal extubation in an academic-based hospital in Iran.

In this preliminary prospective survey, the incidence of immediate major and minor complications associated with tracheal extubation after elective surgery in an academic-based hospital affiliated with Tehran University of Medical Sciences with anesthesiology residents was studied.All patients undergoing intubation in the operating room of Shariati Hospital, during the elective lists from Saturdays to Wednesdays, during two months were enrolled. Emergency patients and patients who had any complication during their intubation such as difficulty in intubation or more than two tries for tracheal intubation and patients who were transferred from the operating rooms to the intensive care unit were not included in the study. Patients with BMI over 35 were also not included in the study. During tracheal extubation and up to recovery, all respiratory adverse events including coughing and bucking, Spo2˂%90, difficult mask ventilation, apnea/hypoventilation, vomiting, laryngospasm, and aspiration were recorded. The time of the day at which complications occurred was also recorded.

Three hundred and seventeen patients were randomly studied. 171 (53.9%) patients were male and 146 (46.0%) of the studied patients were female. Overall, 184 number (58.0%) of all the patients experienced either coughing or bucking on extubation. 29 (9.1%) patients experienced apnea and/or hypoventilation, out of which 8 (2.5%) of them developed laryngospasm which was more frequent in the male population.

In this preliminary survey, it was observed that 59.6% of all the patients experienced at least one of the minor or major respiratory complications of tracheal tube extubation at the end of surgery which was more frequent in women compared to men.