Influencing factors for safety during endotracheal extubation after craniotomy

Abstract

Objective To investigate the current status and risk factors of endotracheal extubation safety after craniotomy. Methods A prospective cohort trial was carried out on 60 patients with endotracheal intubation after craniotomy in the neurosurgical department of our hospital from February to October 2022. There were 19 males (31.7%) and 41 females (68.3%), at an age from 18 to 75 (47.2±15.7) years. The primary outcome was extubation safety based on hemodynamic and respiratory parameters. The clinical data during perioperative and extubation periods were collected. Univariate and multivariate logistic regression analyses were used to screen out the influencing factors for extubation safety. Results Among the 60 subjected patients, the incidence of unsafe extubation was 36.7% (22 cases). Univariate analysis using binary logistic regression showed that the factors affecting the safety of extubation were BMI (OR=1.12, 95%CI: 0.96~1.31), smoking history (OR=5.29, 95%CI: 0.93~30.11), sedation and analgesia before extubation (OR=2.47, 95%CI: 0.76~8.10), Methods of waking up from anesthesia (OR=3.22, 95%CI: 1.05~9.89), comfort of extubation (OR=4.09, 95%CI: 1.31~12.81), and duration of intubation (OR=4.68, 95%CI: 1.43~15.32). Multivariate logistic regression analysis found that the independent risk factors for the safety included spontaneous awakening (OR=10.91, 95%CI: 2.05~58.04), uncomfortable extubation (OR=6.68, 95%CI: 1.42~31.48) and duration of intubation < 24 h (OR=4.65, 95%CI: 1.07~20.17). Conclusion The endotracheal extubation after craniotomy is at high risk of unsafety. Methods of waking up from anesthesia, comfort during extubation, and duration of intubation may influence the safety of extubation.

Keywords

• craniotomy
• postoperative period after general anesthesia
• safety of endotracheal extubation
• influencing factors