A Study of Retained Endotracheal Tube After Neurosurgical Anesthesia: Incidence and Associated Factors

Abstract

Background and objectives: Anesthesia technique for neurosurgery always requires rapid recovery post opesative. However, some patients have a delay recovery from anesthesia after the operation which require retained endotracheal tube. Aim of this study is the retained endotracheal tube incidence after neurosurgical anesthesia and the associated factors.

Methods: The authors studied the records (anesthetic records, in-patient records, investigation data) of patients who received anesthesia for neurosurgery at Srinagarind Hospital, Khon Kaen, Thailand during April to December 2004. The authors looked out for the incidence of retained endotracheal tube after neurosurgical anesthesia (we could not remove endotracheal tube in operation room or post anesthetic care unit) and looked for the associated factors (i.e. surgical associated factors, anesthetic associated factors, and patient associated factors).

Results: The authors gathered the information of 325 patients who received anesthesia for neurosurgery. The incidence of the retained endotracheal tube after neurosurgery was 57.8% (95% CI 52.3, 63.3). The incidence was more common in patients who obtained ASA physical status > 2, who had an emergency surgery, the operation time > 2 hrs, tumor removal operations, undergone aneurysm surgeries, multiple blood transfusion,  and their body temperature < 35˚C.

Conclusion: This study found the high incidence of the retained endotracheal tube after neurosurgical anesthesia (57.8%). Some conditions could be prevented to reduce the incidence. We could improve postoperative care by controlling preventable causes and appropriate post operation care management for unpreventable cause.

Key words: anesthesia, extubation, neurosurgical anesthesia, postoperative period, retained endotracheal tube