Extubation Safety Via Microstream EtCO₂ (IPI) Monitoring

The goal of this clinical trial is to evaluate whether extubation guided by the Integrated Pulmonary Index (IPI)-a composite respiratory score derived from microstream sidestream end-tidal carbon dioxide (EtCO₂) monitoring-improves safety in adults recovering from general anesthesia in the Post-Anesthesia Care Unit (PACU). It will also assess adverse events associated with IPI-guided extubation. The main questions it aims to answer are: 1. Does IPI-guided extubation reduce the incidence of hypoxemia compared to conventional methods? 2. What adverse events (e.g., cardiovascular complications, prolonged hypoxemia) occur with IPI-guided extubation? Researchers will compare the IPI-guided group (extubated when IPI ≥8) to the conventional group (extubated per standard PACU protocols) to determine if IPI monitoring improves extubation outcomes. Participants will:Undergo elective abdominal surgery under general anesthesia with endotracheal intubation. Be randomly assigned to either: 1. Group T (IPI-guided): Receive continuous EtCO₂/IPI monitoring via an endotracheal sampling line, with extubation triggered when IPI ≥8 after spontaneous respiration resumes. 2. Group C (Conventional): Follow standard PACU extubation protocols without IPI monitoring. Have their respiratory status, adverse events (hypoxemia, cardiovascular reactions), and required interventions recorded post-extubation. Participate in satisfaction surveys (patients and PACU nurses) regarding the extubation process.