Anesthesia Related to Reintubation after Planned Extubation Within 24 Hours after General Anesthesia in Srinagarind Hospital: Incidence and Risk Factors

Abstract

Background and Objective : Postoperative reintubation within 24 hours after general anesthesia with endotracheal intubation technique is an important complication of anesthesia services.  It was classified as 1 in 6 of the incidence of the Thai Patient Safety Goals of Department of Anesthesiology in the year 2010 that require surveillance and monitoring. This study aim to analyze the incidence and causes and factors associated with reintubation after planned extubation.

Methods: The retrospective descriptive and analytical study, incidents of reintubation after planned extubation were extracted from the KKU Anesthesiology Risk Management Information System (KKU ARMIS) database conducted between January 1, 2010, and December 31, 2010 and analyzed by using descriptive statistics. Reintubation was defined as intubation after the extubation for the initial endotracheal intubation, for general anesthesia, during 24 hour from the postoperative period.

Results: The incidence of reintubation within 24 hr were 16.9: 10,000. The most common cause was patient factor, immediate postoperative period (41%). The common problems of respiratory system were airway obstruction and pulmonary edema. Inappropriate preoperative evaluation and inappropriate decision making of personnel was the most contributing factor for reintubation.  Factor minimizing incident were increase vigilance during operation and experience hand.

Conclusions: The most common cause of reintubation was patient factor and respiratory problems. Quality assurance with completely preoperative evaluation and vigilance tended to minimize the incidents.

Keywords: General anesthesia, reintubation within 24 hr; incidence, risk factors