COMPARISON OF IMPACT OF POSITIVE PRESSURE VS NEGATIVE PRESSURE EXTUBATION TECHNIQUES ON POST-OPERATIVE HEMODYNAMIC STABILITY AND OXYGEN SATURATION IN PATIENTS UNDERGOING OPEN CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA

Abstract

Background: Post-extubation complications such as desaturation, hypertension, and tachycardia are important concerns under general anesthesia. Positive pressure extubation has long been used, while negative pressure is a newer alternative. Evidence comparing these techniques remains limited and conflicting; therefore, this study compared their impact on hemodynamic stability and oxygen saturation in open cholecystectomy.

Objective: To compare the frequency of complications of positive pressure versus negative pressure extubation technique during emergence from general anesthesia.

Duration: Three months w.e.f. 18-01-2025 to 17-04-2025.

Methodology: After ethical approval and informed consent, 120 patients undergoing open cholecystectomy at Sir Ganga Ram Hospital were randomized into two groups: negative pressure (n=60) and positive pressure (n=60). Extubation techniques were performed as per standard protocols, with oxygen supplementation adjusted to maintain saturation above 90%. All variables were observed and recorded by the researcher. Confounding factors were excluded, complications managed per hospital protocol, and data analyzed using SPSS version 27.

Results: A total of 120 patients (mean age 43.28±12.14 years; 56.7% male; 76.7% ASA-II) were included. Desaturation occurred in 10.0% vs 25.0%, hypertension in 23.3% vs 10.0%, and tachycardia in 10.0% vs 25.0% for Groups A and B, respectively.

Conclusion: Negative pressure extubation was associated with lower rates of desaturation and tachycardia but a higher frequency of hypertension, while positive pressure extubation showed the opposite trend. These results suggest that negative pressure provides better oxygenation outcomes, though with increased hemodynamic stimulation, requiring careful consideration in patients with cardiovascular risk.