Ideally, extubation should be carried out when the patient is awake, and with fully recovered airway reflexes. This is particularly important in those at higher risk of regurgitation.

If extubation is attempted in lighter planes of anaesthesia there is a higher complication rate, particularly laryngospasm and breath holding.

‘Deep’ extubation is a technique where patients are extubated when still quite deeply anaesthetised. Some ENT anaesthetists use this method to extubate after tonsillectomies. These patients must be placed in the lateral position and very carefully monitored in the recovery area.