Effect of Different Degrees of Head End Elevation of the Bed on Respiratory Mechanics during Extubation in Patients Undergoing Routine Surgical Procedures
Anshul Singh, Puneet Khanna, Rajvinder Kaur, Soumya SarkarAbstract
Background:
The effects of positioning the head at 30° and 45° on respiratory mechanics and on the reduction of mechanical ventilation-associated pneumonia are well known in intensive care units, but no studies have evaluated the effects of different head angles during extubation in patients undergoing routine surgical procedures under general anesthesia and this remains a significant controversy.
Methodology:
This prospective, randomized study was conducted after obtaining approval from the Institutional Ethics Committee at All India Institute of Medical Sciences, involving adult patients scheduled for elective lower abdominal surgeries under general anesthesia, aged 18–65 years, with American Society of Anesthesiologists Grades I and II. Patients were randomized according to a computer-generated random number table into three groups. Group A: head end position was maintained at 0°, Group B: 30°, and Group C: 45° for extubation. Respiratory mechanics and hemodynamic parameters were measured every 2 min after changing the position from 0° during extubation.
Results:
There was no statistically significant difference among the three groups in respiratory parameters, including plateau airway pressure, peak airway pressure, expired minute ventilation, and SpO 2 .
Conclusion:
This prospective randomized study demonstrates that various head positions have no effect on respiratory parameters, including tidal volume, oxygen saturation, and airway pressures, in patients undergoing routine lower abdominal procedures under general anesthesia during extubation.