Routine immediate extubation for off-pump coronary artery bypass grafting without XXXX .

@entity1 @entity548 @entity63 @entity1009 @entity1337 @entity358 @entity158 @entity1344 @entity955 @entity583 @entity1937
BACKGROUND: The expansion of coronary surgery on the beating heart without cardiopulmonary bypass has led to increasing interest in ultra-fast track anesthesia, allowing extubation of the @entity1 in the operating theater. The techniques described to date combined general anesthesia with @entity1337 . We report the routine application of a technique that allows immediate extubation in the majority of @entity1 undergoing off-pump coronary artery bypass grafting without @entity1337 . METHODS: Fast-track anesthesia using an ultra-shortacting opiate @entity1937 , without epidural catheter insertion, was used in 160 unselected @entity1 undergoing off-pump coronary artery bypass grafting (aged 43 to 83 years, mean 65 years). There were an average of 2.2 bypass procedures per @entity1 , with the left internal mammary artery used in 93%. Contraindications to immediate extubation were (except for failure to meet standard extubation criteria) @entity1344 and persistent @entity548 at the end of operation. Satisfactory postoperative @entity158 control was achieved by continuous @entity1937 (0.0125 to 0.05 microg x kg(-1) x @entity1009 )). RESULTS: Operating theater extubation within 10 minutes of the end of operation was feasible in 150 @entity1 (94%). Five @entity1 (3%) were extubated within 2 hours, and the remaining 5 @entity1 (3%) were converted to standard anesthesia. There were no deaths during hospitalization. Major complications included @entity583 and transient @entity63 attacks (2 @entity1 each). No @entity358 were seen. Episodes of @entity955 occurred in 21% of the @entity1 undergoing operation. CONCLUSIONS: Immediate extubation is possible in most @entity1 after off-pump coronary artery bypass grafting even without @entity1337 . We believe this type of less invasive cardiac anesthesia is safe and promising.
