title: Early extubation after cardiac surgery: emotional status in the early postoperative period.
abstract: OBJECTIVE
  To compare the emotional state during the first 3 days after coronary artery surgery of patients who had undergone early versus conventional extubation.
  
  
  METHODS
  A prospective, randomized, controlled trial.
  
  
  METHODS
  University hospital, single center.
  
  
  METHODS
  Eligible patients (n = 100) presenting for elective coronary artery surgery, randomized to an early extubation group or a conventional extubation group.
  
  
  METHODS
  Emotional status was measured by the Hospital Anxiety and Depression Scale (HAD), the Self Assessment Manikin (SAM), and the Multiple Affect Adjective Check List-Revised (MAACL-R). Tests were administered preoperatively and on the 1st and 3rd days postoperatively.
  
  
  RESULTS
  Of patients in the conventional extubation group, 30% showed moderate-to-severe depressive symptoms (HAD score >10) on day 3 postoperatively compared with 8% of patients in the early extubation group (p = 0.02). There was a clinically insignificant increase in MAACL-R depression score on the 1st postoperative day within both groups but no other differences within or between groups in SAM or MAACL-R scores.
  
  
  CONCLUSIONS
  Early extubation results in fewer patients displaying depressive symptoms on the 3rd postoperative day but appears to have little effect on other measurements of emotional status. Anesthetic management during coronary artery bypass graft surgery may play an important role in the overall well-being of the patient by decreasing the incidence of postoperative depression.
authors.affiliation: Department of Anaesthesia, St. Vincent's Hospital, University of Melbourne, Victoria, Australia. silberbs@svmh.org.au
authors.forename: B S
authors.initials: BS
authors.lastname: Silbert
authors.forename: J D
authors.initials: JD
authors.lastname: Santamaria
authors.forename: W J
authors.initials: WJ
authors.lastname: Kelly
authors.forename: J L
authors.initials: JL
authors.lastname: O'brien
authors.forename: C M
authors.initials: CM
authors.lastname: Blyth
authors.forename: M Y
authors.initials: MY
authors.lastname: Wong
authors.forename: N B
authors.initials: NB
authors.lastname: Allen
mesh_terms: D000339:Affect; D001026:Coronary Artery Bypass / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004644:Emotions; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013997:Time Factors