DO SHORTER-ACTING NEUROMUSCULAR BLOCKING-DRUGS OR OPIOIDS ASSOCIATE WITH REDUCED INTENSIVE-CARE UNIT OR HOSPITAL LENGTHS OF STAY AFTER CORONARY-ARTERY BYPASS-GRAFTING

Background: The authors hypothesized that shorter-acting opioid and ne uromuscular blocking drugs would be associated with reductions in dura tion of intubation, length of stay (LOS) in the intensive care unit (I CU) after tracheal extubation, or postoperative (exclusive of ICU) LOS , and that shorter durations of intubation mould be associated with re duced ICU LOS after extubation and postoperative (exclusive of ICU) LO S. Methods: One-thousand ninety-four patients undergoing primary coron ary artery bypass graft surgery at 40 academic health centers were stu died. Multiple patient-related factors were included in multivariate m odels for hypothesis testing. Results: The duration of tracheal intuba tion, ICU LOS after extubation, and postoperative (exclusive of ICU) L OS all varied significantly by site, There was no difference between v ecuronium and pancuronium in duration of intubation, ICU LOS after ext ubation, or postoperative (exclusive of ICU) LOS. Use of sufentanil ra ther than fentanyl was associated with a significant (P = 0.045) reduc tion of 1.9 h (95% CI, 0.04 to 4.1 h) in duration of tracheal intubati on but had no significant effect on ICU LOS after extubation, total IC U LOS, postoperative (exclusive of ICU) LOS, or total postoperative LO S, The authors' best model predicts a complex association between incr easing duration of intubation and both ICU LOS after tracheal extubati on and postoperative (exclusive of ICU) LOS, which was associated with an increase in those measures when duration of intubation exceeded 7. 3 or 3 h, respectively. Conclusions: The LOS measures varied considera bly among the institutions. Use of shorter-acting opioid and neuromusc ular blocking drugs had no association with ICU LOS after tracheal ext ubation or with postoperative (exclusive of ICU) LOS, Only when the du ration of intubation exceeded threshold values was it associated with increased LOS measures.