Early extubation following coronary artery bypass surgery: a prospective randomized controlled trial. The Fast Track Cardiac Care Team
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Published on: September 15, 2023
B S Silbert1, J D Santamaria, J L O'Brien
1Department of Anaesthesia, St. Vincent's Hospital, Melbourne, Victoria, Australia.
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 Twenty patients were withdrawn from the study according to protocol guidelines.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.
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