Comparison of Effect of Tracheal Extubation in Supine Versus SemiFowler's Position in Abdominal Onco-Surgeries

Background and Aim: Tracheal extubation is typically conducted while the patient is in a supine position. In patients who have undergone abdominal surgery, adopting a supine position can elevate abdominal wall tension, particularly during actions such as coughing and deep breathing. This increase in tension may exacerbate pain and heighten the risk of abdominal wound dehiscence. The current study sought to evaluate the comfort levels of patients who were extubated while in the semi-Fowler’s position versus those extubated in the supine position. Material and Methods: The current investigation involved a cohort of 100 individuals who had abdominal surgical procedures. Participants were randomly allocated to one of the two designated groups. Group 1 consists of patients who are candidates for extubation while in a supine position. Patients in Group 2 are positioned in semi-Fowler’s for extubation. The endotracheal tube was successfully removed once the patients demonstrated signs of alertness by opening their eyes and regaining consciousness. Vital signs, along with coughing and pain and comfort scores, were meticulously documented before and after extubation, continuing until the patients were discharged from the PACU. Results: The findings indicated that there was no notable difference in the mean duration of epidural analgesia using 0.125% bupivacaine during the intraoperative period when comparing the two groups. The mean visual analogue score (VAS) exhibited a notable difference between the two groups within the 5 to 10 minutes post-extubation period. Group A exhibited higher VAS scores at the 5-minute, 15-minute, and 30-minute time intervals when compared to Group B. In Group A, severe cough and bucking were observed in 5 (10%) and 2 (4%) of the patients, respectively, while these symptoms were not present in Group B. Conclusion: The average respiratory rate returned to its normal baseline within 30 minutes post-extubation while the patient was in the semi-Fowler’s position. Conversely, when in the supine position, the respiratory rate remained elevated. Therapeutic positions guided by turning schedules play a crucial role in sustaining haemodynamic parameters and averting complications.