This study aims to evaluate the impact of different extubation strategy on the occupancy time of operating room (OR) and the incidence of adverse events and quality of recovery after robotic-assisted surgery. The investigators hypothesize that extubation in the post-anesthesia care unit (PACU) may reduce OR occupancy time without increasing adverse events or worsening quality of recovery early after robotic-assisted surgery. This strategy may enhance perioperative efficiency while maintaining clinical safety.
Major surgeries are generally performed under general anesthesia with endotracheal tube. Intubation during anesthesia induction and extubation during anesthesia emergence are two high-risk periods associated with anesthesia-related complications. In clinical practice, extubation is performed either in the OR or in the PACU, according to local routine. Robotic-assisted surgery offers potential clinical benefits but involves high costs and limited resource availability, making operating room (OR) efficiency a critical priority. While extubation in the post-anesthesia care unit (PACU) has been suggested to improve OR turnover, evidence regarding its impact on perioperative efficiency and safety compared to standard OR extubation in robotic surgery is limited. The investigators hypothesize that extubation in the post-anesthesia care unit (PACU) may reduce OR occupancy time without increasing adverse events or worsening quality of recovery early after robotic-assisted surgery. This study aims to evaluate the impact of different extubation strategy on the occupancy time of operating room (OR) and the incidence of adverse events and quality of recovery after robotic-assisted surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
218
At the end of surgery, patients will be transfered from OR to PACU with endotracheal intubation and then extubated in PACU.
At the end of surgery, patients will be extubated in OR and then transfered from OR to PACU.
Peking University Fist Hospital
Beijing, Beijing Municipality, China
RECRUITINGOperating room (OR) occupancy time
Time interval from end of surgery to leaving OR for PACU.
Time frame: Up to 2 hours after surgery
Incidence of emergence delirium
Emergence delirium will be assessed with the confusion assessment method for the intensive care unit (CAM-ICU).
Time frame: Up to 3 hours after surgery
Incidence of adverse events before leaving PACU
An adverse event indicates any unpredictable, unfavourable medical event that is associated with any medical intervention and occurs from end of surgery to the timepoint of leaving PACU.
Time frame: Up to 3 hours after surgery
Time interval from end of surgery to modified Aldrete score of ≥9
Modified Aldrete Score is used to assess post-anesthesia recovery in five aspects (activity, respiration, circulation, consciousness, and oxygenation); scores range from 0 to 10, with higher scores indicating better recovery. A score of ≥9 indicates that patients can be safely transferred from PACU to general wards.
Time frame: Up to 3 hours after surgery
Time interval from end of surgery to PACU discharge
Time interval from end of surgery to PACU discharge.
Time frame: Up to 2 hours after surgery
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