Editor—Tracheal extubation after general anesthesia is a critical event of an anaesthetic, probably more important than induction and intubation of the airway; minor complications can result in significant morbidity and even mortality.12 Both the Fourth National Audit Project and the ASA closed claims analysis reported complications from extubation.34 The Difficult Airway Society developed a systematic approach to anticipated easy extubations and to those deemed difficult. Asleep extubation (commonly referred to as deep extubation), as opposed to awake extubation, is in a different arm of the Difficult Airway Society algorithm from the easy airway extubation.5
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