Extubation Algorithm for Major Neck and Upper Airway Surgery | Society for Head and Neck Anesthesia

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Extubation Algorithm for Major Neck andUpper Airway Surgery

Presented by Laura Cavallone, M.D., Washington University School of Medicine inSt. Louis, Missouri.

Dear SHANA members,

I would like to share with you the “Extubation Algorithm” that I have developed for majorneck and upper airway surgery. I believe it offers a reasonable, pragmatic approach to thishigh-risk patient population, where early extubation failure may occur in nearly 11% of

patients due to postoperative laryngo-pharyngeal edema and airway obstruction.

The “Extubation Algorithm” that is offered for your attention has served me well so far in my practice. Yet, it wasdeveloped 2 years ago, and will certainly benefit from your constructive feedback. The recently published DifficultAirway Society Guidelines for the management of tracheal extubation and ASA Practice Guidelines forManagement of the Difficult Airway have both advanced our appreciation for the clearly defined, preformulatedextubation strategies and the new approaches. For my part, I have adopted the use of remifentanil and/ordexmedetomidine on emergence, when the use of an “advanced technique” is indicated.

In my recent review article, I tried to summarize some of the practical recommendations; however, the evidencebehind different extubation strategies and techniques remains sparse. I am hoping that with the help of theSHANA community we can identify clinically significant and measurable outcomes, to help better define optimalextubation approaches in head and neck surgery. Such validation will most certainly involve a multicenter study,which should be a manageable task for our international society with over 300 members!

I am looking forward to your comments and suggestions. Thank you all in advance for your interest!

Download Extubation Algorithm PDF

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Extubation Algorithm for Major Neck and Upper Airway Surgery | Society for Head and Neck Anesthesia

http://www.shanahq.com/main/content/extubation-algorithm-major-neck-and-upper-airway-surgery[10/11/2013 1:52:30 PM]

Extubation Algorithm for Major Neck and Upper Airway Surgery | Society for Head and Neck Anesthesia

http://www.shanahq.com/main/content/extubation-algorithm-major-neck-and-upper-airway-surgery[10/11/2013 1:52:30 PM]

Extubation Algorithm for Major Neck and Upper Airway Surgery | Society for Head and Neck Anesthesia

http://www.shanahq.com/main/content/extubation-algorithm-major-neck-and-upper-airway-surgery[10/11/2013 1:52:30 PM]

Extubation Algorithm for Major Neck and Upper Airway Surgery | Society for Head and Neck Anesthesia

http://www.shanahq.com/main/content/extubation-algorithm-major-neck-and-upper-airway-surgery[10/11/2013 1:52:30 PM]

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Extubation Algorithm for Major Neck and Upper Airway Surgery | Society for Head and Neck Anesthesia

http://www.shanahq.com/main/content/extubation-algorithm-major-neck-and-upper-airway-surgery[10/11/2013 1:52:30 PM]

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