EXTUBATION UNVEILED: A PROSPECTIVE STUDY OF RECALL OF DISCOMFORT ON TRACHEAL EXTUBATION ON GENERAL ANAESTHESIA

Abstract

Background:

Tracheal extubation is an integral step in general anesthesia recovery and is often accompanied by coughing, agitation, and hemodynamic changes. Although these events are clinically recognized, their recall by patients has not been extensively studied. Awareness of the incidence of recalled discomfort during extubation can aid in optimizing perioperative counseling and airway management strategies.

Objective:

To determine the incidence of recall of discomfort during tracheal extubation following general anesthesia and to assess associations with patient demographics and anesthetic parameters.

Methods:

This prospective observational study was conducted over 12 months at a tertiary care teaching hospital. A total of 140 adult ASA I–II patients undergoing elective surgery under general anesthesia were enrolled. Standardized anesthetic protocols were followed, and extubation was performed per anesthetist’s discretion. Postoperative structured interviews within 24 hours assessed recall of discomfort, tube removal, and first memory post-anesthesia. Descriptive and inferential statistics were applied.

Results:

Of the 140 patients (54% male), most were aged 20–40 years (53%). Endotracheal tube intubation was used in 90% of cases. Only 2% reported remembering tube removal and experiencing discomfort. The majority (98%) had no recall of extubation. First postoperative recollections occurred most often in the ward (55%) or during transfer (29%). No statistically significant association was found between recall and age, sex, or ASA grade.

Conclusion:

Recall of discomfort during tracheal extubation is rare. Observed agitation during emergence does not necessarily correlate with patient memory, supporting extubation timing decisions based on physiological readiness rather than perceived distress.