THE BAILEY MANOEUVRE FOR DEEPEXTUBATION-COMPARISON WITH STANDARD EXTUBATION TECHNIQUE

Dr. A.P. Kataria; Dr. Veena Chatrath; Dr. Dheeru Marwah; Dr. Vikramjit Singh

Volume : IX, Issue : V, May - 2020

THE BAILEY MANOEUVRE FOR DEEPEXTUBATION-COMPARISON WITH STANDARD EXTUBATION TECHNIQUE

Dr. A. P. Kataria, Dr. Veena Chatrath, Dr. Dheeru Marwah, Dr. Vikramjit Singh

Abstract :

BACKGROUND: Traditional awake extubation leads to various respiratory complications; such as respiratory obstruction,coughing, laryngospasm, bucking and hemodynamic response like increase in arterial pressure, heart rate,intracranial and intraocular pressure which can be detrimental in patients who haveundergone intracranial surgery and in patients with coronary artery disease . Settings and Design: This prospective randomized study was conducted in a Tertiary Care Centre in 60 ASA grade I and II patients coming for general surgery. MATERIAL AND METHODS : A prospective randomized observational study was carried out and patientswere divided into 2 groups awake endotracheal extubation group (group E)and exchange extubation group (group S).At the end of surgery in traditional group, awake extubation of ETT was done. In exchange group, 0.3 mg/kg propofol was administered, and the ETT was exchanged for I–gel. Awake extubation of I–gel was then performed. Respiratory complications such as bucking, coughing, desaturation and the need for I–gel repositioning and hemodynamic response were noted. RESULTS: Hemodynamic response measured immediately at extubation in terms of heart rate, systolic blood pressure (BP), diastolic BP and mean arterial pressurewere all significantly lesser in exchange group (group S) when compared to traditional extubation group (group E) .Respiratory complications were significantly more in traditional extubation in) comparison to exchange extubation group (P < 0.001). CONCLUSION : It was concluded that exchange extubation with I–gel decreases hemodynamic stress response and respiratory complications as compared to traditional awake extubation