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Complications at extubation remain an important risk factor in anaesthesia. A postal survey was conducted on extubation practice amongst consultant anaesthetists in the United Kingdom and Ireland. The use of short acting drugs encourages anaesthetists to extubate the trachea at lighter levels of anaesthesia. The results show that oxygen (100%) is not routinely administered either before extubation or en route to the recovery area. A trend towards a head up or sitting position at extubation is emerging. However, further research into the use of these positions is required. Airway related complications at extubation are relatively frequent but are usually dealt with by simple basic measures. The role of drugs such as propofol in decreasing the incidence of these complications needs further evaluation. Some of these results give concern for patient safety and for training. The importance of teaching and adherence to continued oxygenation until complete recovery is strongly emphasised. Nerve stimulators should be used continually as standard monitoring throughout the anaesthetic period when muscle-relaxing drugs are part of the anaesthetic technique. [ABSTRACT FROM AUTHOR]

The article announces the 4th National Audit Project (NAP4) in Great Britain which encourages patients that suffered harm from airway management during anaesthesia to report their cases. It collects data on major complications of airway management resulting in death or brain damage, needle cricothyroidotomy, and Intensive Care Unit admission. NAP4 would focus on cases with poor outcome caused by difficult airway management and will run from September 1, 2008 to August 31, 2009.