CHANGE IN ANESTHESIA PRACTICE AND POSTOPERATIVE SEDATION SHORTENS ICUAND HOSPITAL LENGTH OF STAY FOLLOWING CORONARY-ARTERY BYPASS-SURGERY

We randomized prospectively 144 patients, undergoing elective coronary artery bypass surgery, to either early or to routine extubation [mech anical ventilatory support for 4-7 h (Group A), or 8-14 h (Group B)]. Anaesthesia was modified for both groups. The groups were well matched in terms of sex, age, NYHA class, preoperative left ventricular eject ion fraction, bypass time and aortic cross-clamp time, number of graft s used, and blood units transfused. All patients had normal preoperati ve respiratory, renal, hepatic and cerebral functions. Mechanical vent ilatory support (mean +/- SD) was 6.3 +/- 0.7 h for Group A and 11.6 /- 1.3 h for Group B. Mean ICU stay was 17 +/- 1.3 h for Group A and 2 2 +/- 1.2 h for Group B, while the mean hospital stay was 7.3 +/- 0.8 days and 8.4 +/- 0.9, respectively. There were no statistically signif icant differences in the frequency of all postoperative complications among the two groups. There were no reintubation, readmission to the I CU or death in either group. We concluded that change in anaesthesia p ractice and early postoperative sedation in patients undergoing electi ve coronary artery bypass graft (CABG) surgery resulted in earlier tra cheal extubation. shorter ICU and hospital length of stay without orga n dysfunction or postoperative complications. Early extubation was onl y possible due to the modification of anaesthesia and ICU sedation reg ime.