Early extubation after abdominal aortic reconstruction

To assess the safety of early (<2 hrs) extubation after elective infrarenal aortic surgical procedures.

A retrospective chart review of 192 consecutive elective infrarenal aortic surgical procedures from January 1990 to March 1994 at Mayo Clinic Scottsdale was undertaken.

Combined general and epidural anesthesia was used extensively (187 patients; 97.4%). Early extubation was accomplished in 166 (86.5%) patients. Time to extubation was dependent on clinical factors and not by protocol. All early extubations occurred in the operating room or recovery room with a median time from skin closure of 12 minutes. Ten patients were extubated from 2 to 12 hours after the procedure, 14 patients more than 12 hours after the procedure, and 2 patients were not extubated and subsequently expired. Of the 166 patients extubated within 2 hours, 8 (4.8%) required reintubation. Factors found univariantly to be significantly associated with failure of early extubation include obesity, abnormal chest x-ray postoperatively, prior myocardial infarction, and prior coronary revascularization (p < 0.05).

Early extubation (<2 hrs) after elective infrarenal aortic procedures may be performed safely and should be undertaken unless clinical features suggest failure of extubation.