Context: Endotracheal intubation is the gold standard of a secure airway under general anaesthesia and extubation at the end of surgery is a norm. However this does not happen in all the patients. Delayed extubation after surgery occurs in small percentage of patients due to various reasons which would have been decided preoperatively or sometimes intraoperatively. But sometimes its unexpected due to unanticipated complications in perioperative period.

Aim: This study was conducted to analyze prevalence and causes of delayed extubation among surgical patients.

Setting and Design: It was a one year prospective observational study of patients with delayed extubation after surgical procedures.

Results: Prevalence of delayed extubation among surgical patients operated under anesthesia was 4.32%. Preoperative variable which showed higher percentage of delayed extubation were age above 40 years, male gender, ASA PS II and above. Among operative variables, delayed extubation was seen more in surgical procedures like intraabdominal surgeries and head and neck surgeries and patients under general anesthesia. Delayed extubation was planned in 70.32% of surgical patients. Intraoperative events like hypotension, blood loss, starting of inotropes and duration of surgery also has an influence on delayed extubation.

Conclusion: Delayed extubation, though not frequent, will be required in some surgical patients. It has its own morbidity and mortality. Prolonged intubation and mechanical ventilation after delayed extubation is more harmful as it is associated with complications.