Extubation in the Operating Room - New Era in Cardiac Anaesthesia

Overview

Objective:
To evaluate extubation in the operating room as a routine practice in cardiac anaesthesia.Method: The prospective study enrolled h2 patients without any limitation. The average age was h2 years (4(x78). The surgery procedures includes revascularization procedures (in 73.8% cases without cardiopulmonary bypass), replacements of aortic valve and „redo" operations. The average duration of the operation was 178 minutes (90-300). Pethidine and atropine were used in the premedication. The anaesthesia was maintained with remifentanil, propofol and inhalation anaesthetics. Atracurium was used as a neuromuscular blocking agent. Early postoperative complications (pulmonary, neurologie and renal), postoperative myocardial ischemia, the freyuency of atrial fibrillation and the hospitalization duration of were observed.Results: 59 patients (95.2%) were extubated within S minutes after the end of the operation. In 3 patients (4.8%) we changed the course to the standard anaesthesia practice of our department. The causes of the conversion were intraoperative problems. No patient needs reintubation. There was not observed any death. The rate of early postoperative complications was comparable with the standard cardiac anaesthesia practice. The average duration of hospitalization was h.7 days (3-12).

Key words:
cardiac anaesthesia - extubation in the operating room - minimally invasive cardiac surgery