{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T07:42:33Z","timestamp":1793778153900,"version":"4.6.1"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives:<\/jats:title>\n                    <jats:p>Awake \u201cno touch\u201d extubation requires performing extubations only when the patient spontaneously wakes up without any kind of stimulation during emergence from general anesthesia. The aim of this study was to evaluate absolutely awake extubation \u201cno touch\u201d technique in adult patients, scheduled for elective nasal and paranasal sinus surgeries under general anesthesia as regard to emergence airway complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 60 adult patients were randomly allocated into one of two equal groups according to the method of extubation: Group I: Standard fully awake, Group II: Absolutely \u201cno touch\u201d awake extubation (absolutely no stimulation no touch was allowed until patients were able to open their eyes). The incidence of laryngospasm and its grade according to a four-point scale was reported. Occurrence of airway events (excessive secretions, breath-holding, coughing, hoarseness, biting, as well as the number and severity of any desaturation episodes), oozing from the wound, and postoperative sore throat were also recorded. The heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure measured at the end of surgery served as baseline values, and subsequent measurements were taken within 30 minutes after the end of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There was absolutely no case of laryngeal spasm or episode of desaturation among patients who were extubated with the \u201cno touch\u201d technique. On the other hand, there were 3 cases of laryngeal spasm in standard fully awake group. Severity of coughing, excessive secretions and breath holding, hoarseness, biting, and occurrence of non-purposeful movements of the limbs were significantly less in the absolutely \u201cno touch\u201d technique awake technique. The changes in HR, SBP, and DBP during emergence extubation were significantly less in \u201cno touch\u201d technique technique group. However, oozing from the wound was significantly higher with standard fully awake extubation. However, there were no significant differences between the two groups regarding the incidence of postoperative sore throat (39 and 36%, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The results of the present study showed that awake \u201cno touch\u201d technique technique for tracheal extubation produces less airway-related complications, as well as minimal hemodynamic response during emergence from general anesthesia in nasal and paranasal surgeries. It could be a safe alternative for tracheal extubation in airway surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/1658-354x.82778","type":"journal-article","created":{"date-parts":[[2011,7,7]],"date-time":"2011-07-07T04:52:58Z","timestamp":1310014378000},"page":"125-131","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Evaluation of \u201cno touch\u201d extubation technique on airway-related complications during emergence from general anesthesia"],"prefix":"10.4103","volume":"5","author":[{"given":"Saad A.","family":"Sheta","sequence":"first","affiliation":[{"name":"Department of Oral Maxillofacial Surgery, Dental College, King Saud University, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf A.","family":"Abdelhalim","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Nada","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, National Guard Hospital, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250926","first-page":"149","article-title":"Postoperative tracheal extubation","volume":"80","author":"Miller","year":"1995","journal-title":"Anesth Analg"},{"key":"R2-20250926","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1213\/00000539-199109000-00006","article-title":"Emergence airway complications in children: A comparison of tracheal extubation in awake and deeply anesthetized patients","volume":"73","author":"Patel","year":"1991","journal-title":"Anesth Analg"},{"key":"R3-20250926","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1097\/00000542-199005000-00010","article-title":"Adverse respiratory events in anesthesia: A closed claims analysis","volume":"72","author":"Caplan","year":"1990","journal-title":"Anesthesiology"},{"key":"R4-20250926","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1213\/00000539-199811000-00036","article-title":"Cough during emergence from isoflurane anaesthesia","volume":"87","author":"Kim","year":"1998","journal-title":"Anesth Analg"},{"key":"R5-20250926","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1093\/bja\/46.4.315-a","article-title":"Changes in intracranial pressure and systemic arterial pressure during termination of anaesthesia","volume":"46","author":"Leech","year":"1974","journal-title":"Br J Anaesth"},{"key":"R6-20250926","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/S0952-8180(01)00299-9","article-title":"Suppression of cough during emergence from general anaesthesia: Laryngotracheal lidocaine through a modified endotracheal tube","volume":"13","author":"Diachun","year":"2001","journal-title":"J Clin Anesth"},{"key":"R7-20250926","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/0952-8180(94)00024-X","article-title":"Alfentanil suppresses coughing and agitation during emergence from isoflurane anesthesia","volume":"7","author":"Mendel","year":"1995","journal-title":"J Clin Anesth"},{"key":"R8-20250926","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1213\/01.ANE.0000097185.70171.89","article-title":"The incidence of laryngospasm with a \u201cNo Touch\u201d extubation technique after tonsillectomy and adenoidectomy","volume":"98","author":"Tsui","year":"2004","journal-title":"Anesth Analg"},{"key":"R9-20250926","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1017\/S0022215100069218","article-title":"Effects of anaesthesia upon intrinsic laryngeal reflexes","volume":"82","author":"Wyke","year":"1968","journal-title":"J Laryngol Otol"},{"key":"R10-20250926","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1046\/j.1365-2044.1998.00397.x","article-title":"Respiratory complications associated with tracheal extubation. 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