Ability to Maintain Saturation Levels Without Oxygen Supplementation as a Extubation Criteria Without TOF Monitoring Equipment

Launched by UNIVERSITY OF SURABAYA · Feb 15, 2024

Keywords

ClinConnect Summary

The availability of Train-of-Four (TOF) monitoring devices is not yet widespread in some clinical practices. Practitioners are also often unaware of the high incidence of residual paralysis and the associated risks in their daily practice. However, residual paralysis increases the occurrence of airway obstruction, hypoxemia, and postoperative pulmonary complications. Therefore, clinical parameters for extubation criteria must ensure the absence of residual paralysis.

Administering oxygen in the ambient air can identify hypoventilation conditions. Therefore, patients who can maintain oxygen...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Elective surgery
• • 2. Adult patiens aged 18-60 years
• • 3. ASA physical status I-II
• • 4. Not receiving oxygen supplementation during pre-operative care
• Exclusion Criteria:
• • 1. History of hypersensitivy or allergy to neostigmine, muscular blockade agents, or anesthetic agents given
• • 2. Head or neck surgery
• • 3. Inability to access the ulnar nerve for TOF measurement device placement
• • 4. History of lung diseases such asthma, COPD, or pleural effusion
• • 5. Hepatic impairment with liver enzyme values \> 50% of the normal range
• • 6. Renal insufficiency (serum creatinine \> 1.8 mg/dl) or kidney failure
• • 7. Patients with neuromuscular diseases
• • 8. Body mass index (BMI) \> 35 kg/m2
• • 9. Consumption of medications that affect neuromuscular transmission such as aminoglycoside, polymyxin, lincomycin, clindamycin, and tetracycline; local anesthetic agent, procainamide, quinidine, lithium, magnesium sulfate, furosemide, cyclosporine, dantrolene, anti-estrogens, anticonvulsant, calcium, steroid, and azathioprine.
• • 10. Patients with contraindications to neostigmine or atropine sulfate
• • 11. Planned post-operative intensive care unit treatment