about deep extubation...

[ketap]

hi, i just want to ask :
1. how do u regularly perform deep extubation?
2. is it true if there is such thing as MAC extubation that we can use as our guideline for performing deep extubation? if there's such thing like that, where could i learn about this? i've heard about this from some of my friends, but they don't know what it is exactly either...please help me...thx u

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[Planktonmd]

hi, i just want to ask :
1. how do u regularly perform deep extubation?
2. is it true if there is such thing as MAC extubation that we can use as our guideline for performing deep extubation? if there's such thing like that, where could i learn about this? i've heard about this from some of my friends, but they don't know what it is exactly either...please help me...thx u

Deep extubation is done by keeping a surgical level of anesthesia and pulling the tube out before any of the airway reflexes are back.
It is basically converting a GA with ETT into a GA with mask and frequently oral airway.
If you lighten the anesthetic before pulling the tube out you might be approaching an anesthetic level where you could cause laryngospasm (stage 2 anesthesia).

 

[SleepIsGood]

hi, i just want to ask :
1. how do u regularly perform deep extubation?
2. is it true if there is such thing as MAC extubation that we can use as our guideline for performing deep extubation? if there's such thing like that, where could i learn about this? i've heard about this from some of my friends, but they don't know what it is exactly either...please help me...thx u

Yes there is a theoretical level at which you are supposed to deeply extubate the patient..its something like 2.0MAC (something ridiculous). I dont think anyone does this even though that's what's supposed to be done since you would get hemodynamic compromise.

Usually nowadays people get pts to breath on their own while surgical anesthesia is maintained (1.0-1.3 MAC)..they pull the tube and support the a/w.

 

[dhb]

1: all the time
2: provided the patient is not in stage two you can pull the tube anytime you want if the patient is spontaneously breathing

 

[ketap]

wow, great answers..that's exactly what i need..thx ,guys