Extubation Algorithm for Major Neck and Upper Airway Surgery | Society for Head and Neck Anesthesia http://www.shanahq.com/main/content/extubation-algorithm-major-neck-and-upper-airway-surgery[10/11/2013 1:52:30 PM] Login Join SHANA SHANA Mail Feedback Extubation Algorithm for Major Neck and Upper Airway Surgery Presented by Laura Cavallone, M.D., Washington University School of Medicine in St. Louis, Missouri. Dear SHANA members, I would like to share with you the “Extubation Algorithm” that I have developed for major neck and upper airway surgery. I believe it offers a reasonable, pragmatic approach to this high-risk patient population, where early extubation failure may occur in nearly 11% of patients due to postoperative laryngo-pharyngeal edema and airway obstruction. The “Extubation Algorithm” that is offered for your attention has served me well so far in my practice. Yet, it was developed 2 years ago, and will certainly benefit from your constructive feedback. The recently published Difficult Airway Society Guidelines for the management of tracheal extubation and ASA Practice Guidelines for Management of the Difficult Airway have both advanced our appreciation for the clearly defined, preformulated extubation strategies and the new approaches. For my part, I have adopted the use of remifentanil and/or dexmedetomidine on emergence, when the use of an “advanced technique” is indicated. In my recent review article, I tried to summarize some of the practical recommendations; however, the evidence behind different extubation strategies and techniques remains sparse. I am hoping that with the help of the SHANA community we can identify clinically significant and measurable outcomes, to help better define optimal extubation approaches in head and neck surgery. Such validation will most certainly involve a multicenter study, which should be a manageable task for our international society with over 300 members! I am looking forward to your comments and suggestions. Thank you all in advance for your interest! Download Extubation Algorithm PDF Join SHAN FREE annual m through Octobe Featured Case All Cases Featured Video Preview Full View (Memb All Videos Featured Article All Articles Featured Interview All Interviews SHANA Forum SHANA Library SHANA Gallery Technology Links Home FREE MEMBERSHIP FEATURED QUICK CONNECT SUGGEST and SUBMI Home About Education Research Communications Forum Library Gallery Patients Membership