Modified Deep Extubation vs. Standard Awake Extubation
Trial Parameters
Brief Summary
The proposed study is to compare a modified DE technique, which is regularly used for low-risk patients by staff anesthesiologists at our institution, to a standard awake extubation. This modified deep extubation (mDE) occurs while the patient is still anaesthetized but at a lower dose of anaesthetic gas than previously described, and balanced with long acting opioids to attenuate the airway reaction. As previously stated, the literature shows that the risks of DE are equivalent to those of regular AE practice. Our hypothesis is that mDE will shorten the time from the end of the surgery (completion of last stitch) to the moment the patient is ready to leave the OR by at least 5 minutes when compared to standard AE practice.
Eligibility Criteria
Inclusion Criteria: * ASA I-III * laparoscopic surgery under general anesthesia Exclusion Criteria: * High-risk patients: * Documented difficult airway during intubation or developed intraoperatively. * Full stomach * Pregnant women * Emergency surgery * BMI\>30 * Intraoperative bleeding leading to transfusion * Use of remifentanil during extubation * Requirement for prone position for surgical approach (i.e., spine surgery, anal fistulectomy, tumor resection of the back, etc) * Absolute indication for awake or deep extubation * Use of opioids in chronic pain patients