Early extubation after coronary artery surgery in efficiently rewarmed patients: A postoperative comparison of opioid anesthesia versus inhalational anesthesia and thoracic epidural analgesia

Efficacy of Parasternal Injection of Bupivacaine on Postopeartive Pain for Early Extubation in Patients Undergoing Coronary Artery Bypass Surgery

“…In fact, it has been proposed that early extubation should decrease the incidence of nosocomial pneumonias. The intrapulmonary shunt fraction improved significantly among patients extubated early [7,13,14]. Moreover, mechanical ventilation itself can impair venous return and decrease cardiac output, thus prolonging Intensive Care Unit stay for adjustment of these parameters.…”

“…Panagiotakopoulos V showed that 64% of patients didn't experience any significant pain at all, 29% experienced improved pain compared with the other cardiac surgical patients and only 7% of the patients enrolled in this study experienced the "usual" pain [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

A prospective randomized study of intraoperative thoracic epidural analgesia in off-pump coronary artery bypass surgery

“…TEA has been used for coronary artery surgery since 1989 at a few centers [8]. Though randomized studies [9] of TEA have been unable to report effects on main outcomes in patients undergoing OPCABs, probably because of insufficient statistical power, TEA has recently gained popularity because of its potential beneficial effects on the perioperative stress response, analgesia, and postoperative pulmonary function.…”

Anaesthesia for coronary artery surgery — a plea for a goal-directed approach

“…148-150 The peak incidence of postoperative ischaemia is within the first two to four hours after bypass during which rewarming is accomplished, so Optimally rewarming is complete before extubation to prevent excessive work for the cardiopulmonary system with the possibility that respiratory failure might necessitate reintubation of the trachea (Figure 2 The criteria developed in Table IV arose out of the results of a number of studies, mostly non-randomized, which looked at consecutive attempts at early extubation. IS3- 160 The majority of studies have demonstrated the practice to be safe.…”