As surgery concludes, a plan must be in place regarding the conditions for tracheal extubation (Table 42-13: Causes of Delayed Emergence from Anesthesia in Children).
- The train-of-four twitch response should be assessed, and if at least one twitch is present, neuromuscular blockade should be antagonized.
- There are very few surgical or medical indications to remove the airway during a deep level of anesthesia.