Early extubation following coronary artery bypass surgery: a prospective randomized controlled trial. The Fast Track Cardiac Care Team.
OBJECTIVE
To determine the safety of early extubation (EE) after coronary artery surgery.


METHODS
Prospective randomized controlled trial.


METHODS
The cardiac surgery operating room and ICU of a university-affiliated teaching hospital.


METHODS
One hundred eligible patients presenting for elective coronary artery surgery.


METHODS
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).


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 Twenty patients were withdrawn from the study according to protocol guidelines.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.
Silbert
B S
BS
Department of Anaesthesia, St. Vincent's Hospital, Melbourne, Victoria, Australia.
Santamaria
J D
JD
O'Brien
J L
JL
Blyth
C M
CM
Kelly
W J
WJ
Molnar
R R
RR
D000758:Anesthesia; D018686:Anesthetics, Intravenous; D001026:Coronary Artery Bypass; D005260:Female; D005283:Fentanyl; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D011446:Prospective Studies; D012121:Respiration, Artificial; D013997:Time Factors
D018686:Anesthetics, Intravenous; D005283:Fentanyl