Risk factors for delayed extubation in thoracic and lumbar spine surgery: a retrospective analysis of 135 patients

Li, Fenghua; Gorji, Reza; Tallarico, Richard A.; Dodds, Charles; Modes, Katharina; Mangat, Sukhpal; Yang, Zhong-Jin

doi:10.1007/s00540-013-1689-2

Cited by 22 publications

(11 citation statements)

References 13 publications

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“…Epstein and Dexter (2013) investigated the relationship between prolonged extubation and OR cost, and concluded that prolonged extubation time should be treated as resulting in proportionally increased variable costs [32]. In addition, 55.6% of the cases with prolonged extubation occurred during cases on regular workdays and in an OR with more than eight hours of cases and turnover [32,33]. Another study conducted by the same group demonstrated that the mean time from end of surgery to exit from the OR was at least 12.6 minutes longer in cases with prolonged extubation, and that the percentage of cases for which the extubation was prolonged (among anesthesia for intraperitoneal procedures in the lower abdomen) was 13.3% ± 0.5% [7].…”

Section: Discussionmentioning

confidence: 99%

“…These factors included prone position, prolonged surgical time, significant blood loss, larger volume of crystalloid and colloid infusion, procedure, and surgeon [7,33]. Lai and Chan (2015) reported that DES anesthesia, longer anesthesia time, higher BMI, and shorter surgical time contribute to slower emergence in gynecologic laparoscopic surgery [15].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Anesthesia-Controlled Operating Room Time between Propofol-Based Total Intravenous Anesthesia and Desflurane Anesthesia in Open Colorectal Surgery: A Retrospective Study

et al. 2016

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We conducted a retrospective study to investigate the anesthesia-controlled time and factors that contribute to prolonged extubation in open colorectal surgery. Using our hospital database, demographic data, various time intervals (waiting for anesthesia time, anesthesia time, surgical time, emergence time, exit from operating room after extubation, total operating room time, and post-anesthesia care unit stay time), and incidence of prolonged extubation (≥ 15 mins), were compared between patients who received desflurane/fentanyl-based anesthesia and total intravenous anesthesia via target-controlled infusion with fentanyl/propofol. Logistic regression analyses were performed to assess the association between variables that contributed to prolonged extubation. In conclusion, the anesthesia-controlled time was similar in desflurane anesthesia and propofol-based total intravenous anesthesia for open colorectal surgery in our hospital. Surgical time greater than 210 minutes, as well as age, contributed to prolonged extubation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of Anesthesia-Controlled Operating Room Time between Propofol-Based Total Intravenous Anesthesia and Desflurane Anesthesia in Open Colorectal Surgery: A Retrospective Study

et al. 2016

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“…There were studies that investigated the confounding risk factors of prolonged extubation which included prone position, prolonged surgical time, significant blood loss, and larger volume of crystalloid and colloid infusion. [ 6 , 26 , 27 ] Our previous study reported that DES anesthesia, lengthy anesthesia time, higher BMI, and shorter surgical time contribute to slower emergence in gynecologic laparoscopic surgery. [ 14 ] In addition, Chan et al [ 19 ] demonstrated that the confounding factors that predicted awaken under TCI with propofol are age, gender, and times of surgery and anesthesia (total consumption dose of propofol and fentanyl) in assortments of surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Fifth, we did not include patients receiving Whipple operation and blood loss >1500 mL because larger volume of fluid infusion may be the risk factor for delayed extubation. [ 26 ] Finally, we did not use BIS in our common practice. But the depth of anesthesia was monitored by the experienced anesthesiologist, and our percentage of prolonged extubation was 9.6% less than overall 15.4% reported by a previous study.…”

Section: Discussionmentioning

confidence: 99%

Planning for operating room efficiency and faster anesthesia wake-up time in open major upper abdominal surgery

Lai

Chan

et al. 2017

Medicine

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Reducing anesthesia-controlled time (ACT) may improve operation room (OR) efficiency result from different anesthetic techniques. However, the information about the difference in ACT between desflurane (DES) anesthesia and propofol-based total intravenous anesthesia (TIVA) techniques for open major upper abdominal surgery under general anesthesia (GA) is not available in the literature.This retrospective study uses our hospital database to analyze the ACT of open major upper abdominal surgery without liver resection after either desflurane/fentanyl-based anesthesia or TIVA via target-controlled infusion with fentanyl/propofol from January 2010 to December 2011. The various time intervals including waiting for anesthesia time, anesthesia time, surgical time, extubation time, exit from OR after extubation, total OR time, and postanesthetic care unit (PACU) stay time and percentage of prolonged extubation (≥15 minutes) were compared between these 2 anesthetic techniques.We included data from 343 patients, with 159 patients receiving TIVA and 184 patients receiving DES. The only significant difference is extubation time, TIVA was faster than the DES group (8.5 ± 3.8 vs 9.4 ± 3.7 minutes; P = 0.04). The factors contributed to prolonged extubation were age, gender, body mass index, DES anesthesia, and anesthesia time.In our hospital, propofol-based TIVA by target-controlled infusion provides faster emergence compared with DES anesthesia; however, it did not improve OR efficiency in open major abdominal surgery. Older, male gender, higher body mass index, DES anesthesia, and lengthy anesthesia time were factors that contribute to extubation time.

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“…The risk factors of prolonged extubation including prone position, prolonged surgical time, significant blood loss, larger volume of crystalloid and colloid infusion, procedure, or surgeon. [ 20 , 24 ] In addition, more than half of the cases with prolonged extubation occurred during cases on regular workdays and in an OR with >8 hours of cases and turnover. [ 23 ] The result was consisted with the previous reports, as we showed prolonged extubation was associated with anesthetic and surgical time.…”

Section: Discussionmentioning

confidence: 99%

Analysis of anesthesia-controlled operating room time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in functional endoscopic sinus surgery

Liu

Lai

et al. 2018

Medicine

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Anesthesia technique may contribute to the improvement of operation room (OR) efficiency by reducing anesthesia-controlled time. We compared the difference between propofol-based total intravenous anesthesia (TIVA) and desflurane anesthesia (DES) for functional endoscopic sinus surgery (FESS) undergoing general anesthesiaWe performed a retrospective study using data collected in our hospital to compare the anesthesia-controlled time of FESS using either TIVA via target-controlled infusion with propofol/fentanyl or DES/fentanyl-based anesthesia between January 2010 and December 2011. The various time intervals (surgical time, anesthesia time, extubation time, total OR stay time, post anesthesia care unit [PACU] stay time) and the percentage of prolonged extubation were compared between the 2 anesthetic techniques.We included data from 717 patients, with 305 patients receiving TIVA and 412 patients receiving DES. An emergence time >15 minutes is defined as prolonged extubation. The extubation time was faster (8.8 [3.5] vs. 9.6 [4.0] minutes; P = .03), and the percentage of prolonged extubation was lower (7.5% vs. 13.6%, risk difference 6.1%, P < .001) in the TIVA group than in the DES group. However, there was no significant difference between ACT, total OR stay time, and PACU stay time.In our hospital, propofol-based TIVA by target-controlled infusion provide faster emergence and lower chance of prolonged extubation compared with DES anesthesia in FESS. However, the reduction in extubation time may not improve OR efficiency.

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Risk factors for delayed extubation in thoracic and lumbar spine surgery: a retrospective analysis of 135 patients

Cited by 22 publications

References 13 publications

Comparison of Anesthesia-Controlled Operating Room Time between Propofol-Based Total Intravenous Anesthesia and Desflurane Anesthesia in Open Colorectal Surgery: A Retrospective Study

Comparison of Anesthesia-Controlled Operating Room Time between Propofol-Based Total Intravenous Anesthesia and Desflurane Anesthesia in Open Colorectal Surgery: A Retrospective Study

Planning for operating room efficiency and faster anesthesia wake-up time in open major upper abdominal surgery

Analysis of anesthesia-controlled operating room time after propofol-based total intravenous anesthesia compared with desflurane anesthesia in functional endoscopic sinus surgery

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