Comparison of Spontaneous Ventilation Time in Air Without Desaturation After Positive Pressure Extubation Versus Aspiration Extubation When Awakening From General Anesthesia

• presence/absence of a desaturation after extubation [ Time Frame: 10 minutes ] [ Designated as safety issue: Yes ]
  desaturation is defined as an SpO2<92%
• minimum Sp02 level after extubation (%) [ Time Frame: 10 minutes ] [ Designated as safety issue: Yes ]
• minimum Sp02 level after extubation (%) [ Time Frame: 60 minutes ] [ Designated as safety issue: Yes ]
• presence/absence of complications [ Time Frame: 60 minutes ] [ Designated as safety issue: Yes ]
  coughing, airway obstruction, laryngospasm, desaturation, apnea, vomiting in the first hour
• presence / absence of therapeutic maneuvers [ Time Frame: 60 minutes ] [ Designated as safety issue: Yes ]
  includes oxygen therapy (or bezel ventimasque), Guedel airway, mask assistance, re-intubation during the first hour
• presence/absence of any complication [ Time Frame: 60 minutes ] [ Designated as safety issue: Yes ]

The primary objective is to show that positive pressure extubation improves oxygenation immediately after extubation compared to extubation via "aspiration" by evaluating and comparing the onset time of desaturation during spontaneous ventilation during awakening following general anesthesia.

• Procedure: Positive pressure extubation
  Positive pressure extubation will be used for patients waking up from general anesthesia
• Procedure: Aspiration/suction extubation
  Aspiration/suction extubation will be used for patients waking up from general anesthesia

• Active Comparator: Positive pressure extubation
  Positive pressure extubation will be used for patients waking up from general anesthesia in this group
  Intervention: Procedure: Positive pressure extubation
• Active Comparator: Aspiration/suction extubation
  Aspiration/suction extubation will be used for patients waking up from general anesthesia in this group
  Intervention: Procedure: Aspiration/suction extubation

Inclusion Criteria:

• The patient must have given his/her informed and signed consent
• The patient must be insured or beneficiary of a health insurance plan
• The patient is available for 1 hour of follow up
• ASA 1 to 3
• The patient is schedules for orthopedic surgery (limbs) with general anesthesia

Exclusion Criteria:

• The patient is participating in another study
• The patient is in an exclusion period determined by a previous study
• The patient is under judicial protection, under tutorship or curatorship
• The patient refuses to sign the consent
• It is impossible to correctly inform the patient
• The patient is pregnant
• The patient is breastfeeding
• Chronic respiratory insufficiency
• Cardiopathy
• Obstructive sleep apnea
• Two or more predictive criteria for difficult mask ventilation (age > 55 years, toothless, beard, snorer, BMI > 26)
• No predictive criteria for difficult intubation (SPIDS <= 10)