Extubation [Neurosurgery Wiki]

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====== Extubation ====== 

Removal of a [[tube]] from an organ, structure, or orifice; specifically, removal of the [[endotracheal tube]] after [[intubation]].

===== Facilitation =====

[[Dexmedetomidine]] (Precedex®). Alpha 2 [[adrenergic receptor]] agonist, used for control of [[hypertension]] postoperatively, as well as for its sedating qualities during [[awake craniotomy]] either alone or in conjunction with [[propofol]]. Also used to help patients tolerate [[endotracheal tube]]s without [[sedative]]s/[[narcotic]]s to facilitate [[extubation]].

===== Extubation time =====

[[Extubation time]]
===== Early extubation =====

see [[Early extubation]].

===== Delayed Extubation =====
[[Delayed Extubation]] .

===== Terminal extubation =====

[[Terminal extubation]].

===== Timing of extubation =====

Level III: In [[Head injury]] early extubation for patients meeting extubation criteria does not increase the risk of [[pneumonia]].

In Surgical [[clipping]] of VA-PICA junction, saccular aneurysms when [[neurapraxia]] of the lower cranial nerves is likely (in cases of difficult dissection or traction applied during clipping) the patient is kept intubated overnight. Patients who do not tolerate [[extubation]] at this point are immediately reintubated and elective [[tracheostomy]] is scheduled. [[Tracheostomy]] is maintained until the [[neurapraxia]] resolves.