EARLY EXTUBATION FOLLOWING CORONARY-ARTERY BYPASS-SURGERY - A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Study objectives: To determine the safety of early extubation (EE) aft er coronary artery surgery. Design: Prospective randomized controlled trial. Setting: The cardiac surgery operating room and ICU of a univer sity-affiliated teaching hospital. Patients: One hundred eligible pati ents presenting for elective coronary artery surgery. Interventions: P atients randomized to the EE group were administered a reduced dose of fentanyl (15 mu g/kg) and an anesthetic compatible with EE, while pat ients randomized to the conventional extubation (CE) group were given fentanyl (50 mu g/kg). Measurements and results: The time to extubatio n in the EE group (median, 240 min; range, 30 to 930 min) was signific antly 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 Twenty patients were withdrawn from the study according to protocol guidelines.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 complicat ions attributable to EE. Conclusions: By using an appropriate anesthet ic technique and postoperative management, EE can be achieved followin g coronary artery bypass surgery without major complications.