To ensure timely wake up at the end of the procedures, anesthetic medications should be discontinued at an appropriate time based on medication half-life and pharmacodynamics. A common practice is to reduce the concentration of potent inhaled anesthetics and administer nitrous oxide. When using remifentanil, this should be slowly titrated in 30 minutes to avoid postoperative hyperalgesia. Before proceeding with emergence, adequate pain control should be ensured. Patients should be normothermic, hemodynamically stable, and with normal gas-exchange and metabolic status. Reversal of paralysis should be ensured using a quantitative assessment, such as a train-of-four with accelerometer, and muscle relaxant reversal should be administered when appropriate. In some instances, a deep extubation technique might be preferable. These situations include asthmatic patients at higher risk of bronchospasm during airway manipulation, patients at risk of bleeding due to cough and increased intrathoracic pressure (such as during neck or brain surgery), or patients with respiratory infectious disease.