[Fast-track management for conventional coronary artery bypass surgery]

Area of Science:

• Cardiovascular Surgery
• Anesthesiology
• Critical Care Medicine

Context:

• Coronary artery bypass grafting (CABG) is a major cardiac surgery.
• Off-pump CABG has gained popularity due to its association with early hospital discharge.
• Conventional on-pump CABG may also benefit from fast-track management strategies.

Purpose:

• To evaluate the feasibility and safety of fast-track anesthesia in on-pump CABG patients.
• To assess the potential for early hospital discharge and recovery using epidural analgesia and autologous blood transfusion.

Summary:

• This study involved 19 patients undergoing on-pump CABG with fast-track anesthesia, including high thoracic and lumbar epidural analgesia and pre-operative autologous fresh blood transfusion.
• Patients experienced a mean blood loss of 283 ml within 6 hours post-surgery.
• Nine patients were extubated in the operating room, and 17 patients were able to eat on the day after surgery.

Impact:

• The implemented fast-track techniques facilitated early extubation and oral intake post-on-pump CABG.
• No complications were reported in the study cohort, suggesting the safety of this approach.
• This strategy may pave the way for reduced hospital stays and improved patient recovery in conventional CABG procedures.