ETT - the patient will be turned 180 degrees, so ensure there's adequate extension on the circuit. Ensure the ETT is secured very well. The surgeon will have the neck and chin prepped and draped so there will be very little access to the airway. Extubate Awake - Since the greater majority of these patients have a severe form of sleep apnea, it is best practice to wake the patient before extubating.
This is a second line intervention for sleep apnea. The patient typically needs to fail CPAP usage in order to have this intervention prescribed. The surgery places a stimulator on the hypoglossal nerve. The stimulator increases glossal tone during inspiration, which helps keep the airway open. The stimulator is user-programmed such that it can begin stimulation only after a designated period of time. This allows a period of time for patient to fall asleep as normal before stimulation begins.
