Early extubation following coronary artery bypass surgery : A Prospective randomized controlled trial

• Published in: Chest Vol. 113; no. 6; pp. 1481 - 1488
• Main Authors: SILBERT, B. S, SANTAMARIA, J. D, O'BRIEN, J. L, BLYTH, C. M, KELLY, W. J, MOLNAR, R. R
• Format: Journal Article
• Language: English
• Published: Northbrook, IL American College of Chest Physicians 01.06.1998
• Subjects: Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Medical sciences; Thoracic and cardiovascular surgery. Cardiopulmonary bypass; Human; Postoperative; Tolerance; General anesthesia; Cardiovascular disease; Method; Coronary heart disease; Extubation; Treatment; Aortocoronary; Bypass; Surgery; Early
• ISSN: 0012-3692; 1931-3543
• DOI: 10.1378/chest.113.6.1481

STUDY OBJECTIVES: To determine the safety of early extubation (EE) after coronary artery surgery. DESIGN: Prospective randomized controlled trial. SETTING: The cardiac surgery operating room and ICU of a university-affiliated teaching hospital. PATIENTS: One hundred eligible patients presenting for elective coronary artery surgery. INTERVENTIONS: Patients randomized to the EE group were administered a reduced dose of fentanyl (15 microg/kg) and an anesthetic compatible with EE, while patients randomized to the conventional extubation (CE) group were given fentanyl (50 microg/kg). MEASUREMENTS AND RESULTS: The time to extubation in the EE group (median, 240 min; range, 30 to 930 min) was significantly less than the CE group (median, 420 min; range, 125 to 1,140 min) (p<0.01). Twenty patients were withdrawn from the study according to protocol guidelines. There were no cases of reintubation or complications attributable to EE. CONCLUSIONS: By using an appropriate anesthetic technique and postoperative management, EE can be achieved following coronary artery bypass surgery without major complications.