Feasibility of On-table Extubation After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial

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TOTONCHI ZIAE; AZARFARIN RASOUL; Jafari Louise; ALIZADEH GHAVIDEL ALIREZA; BAHARESTANI BAHADOR; ALIZADEHASL AZIN; MOHAMMADI ALASTI FARIDEH; GHAFFARI NEJAD MOHAMMAD HASSAN

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Journal: Anesthesiology and Pain Medicine Year:2018 | Volume:8 | Issue:5 Page(s): 0-0

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Title

Feasibility of On-table Extubation After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial

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Keywords

Anesthesia

Cardiopulmonary Bypass

Cardiac Surgery

Monitoring

Early Extubation

Abstract

Background: The use of short-acting anesthetics, muscle relaxation, and Anesthesia depth Monitoring allows maintaining sufficient Anesthesia depth, fast recovery, and extubation of the patients in the operating room (OR). We evaluated the feasibility of extubation in the OR in Cardiac Surgery. Methods: This clinical trial was performed on 100 adult patients who underwent elective noncomplex Cardiac Surgery using Cardiopulmonary Bypass. Additional to the routine Monitoring, the patients' depth of Anesthesia and neuromuscular blocked were assessed by bispectral index and nerve stimulator, respectively. In the on-table extubation (OTE) group (n = 50), a limited dose of sufentanil (0. 15 µ g/kg/h) and inhalational anesthetics were used for early waking. In the control group (n = 50), the same Anesthesia-inducing drugs were used but the dose of sufentanil during the operation was 0. 7-0. 8 µ g/kg/h. After the operation, cardiorespiratory parameters and ICU stay were documented. Results: Demographic and clinical variables were comparable in both study groups. In the OTE group, we failed to extubate two patients in the OR (success rate of 96%). There were no significant differences between the two groups in terms of systolic and diastolic blood pressure at the time of entering the ICU (P > 0. 05). Heart rate was lower in the OTE than in the control group at ICU admission (89. 4 ± 13. 1 vs. 97. 6 ± 12. 0 bpm; P = 0. 008). The ICU stay time was lower in the OTE group (34 (21. 5-44) vs. 48 (44-60) h; P = 0. 001). Conclusions: Combined inhalational-intravenous Anesthesia along with using multiple Anesthesia Monitoring systems allows reducing the dose of total anesthetics and maintaining adequate Anesthesia depth during noncomplex Cardiac Surgery with Cardiopulmonary Bypass. Thus, extubation of the trachea in the OR is feasible in these patients.

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APA: Copy

TOTONCHI, ZIAE, AZARFARIN, RASOUL, Jafari, Louise, ALIZADEH GHAVIDEL, ALIREZA, BAHARESTANI, BAHADOR, ALIZADEHASL, AZIN, MOHAMMADI ALASTI, FARIDEH, & GHAFFARI NEJAD, MOHAMMAD HASSAN. (2018). Feasibility of On-table Extubation After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial. ANESTHESIOLOGY AND PAIN MEDICINE, 8(5), 0-0. SID. https://sid.ir/paper/772850/en

Vancouver: Copy

TOTONCHI ZIAE, AZARFARIN RASOUL, Jafari Louise, ALIZADEH GHAVIDEL ALIREZA, BAHARESTANI BAHADOR, ALIZADEHASL AZIN, MOHAMMADI ALASTI FARIDEH, GHAFFARI NEJAD MOHAMMAD HASSAN. Feasibility of On-table Extubation After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial. ANESTHESIOLOGY AND PAIN MEDICINE[Internet]. 2018;8(5):0-0. Available from: https://sid.ir/paper/772850/en

IEEE: Copy

ZIAE TOTONCHI, RASOUL AZARFARIN, Louise Jafari, ALIREZA ALIZADEH GHAVIDEL, BAHADOR BAHARESTANI, AZIN ALIZADEHASL, FARIDEH MOHAMMADI ALASTI, and MOHAMMAD HASSAN GHAFFARI NEJAD, “Feasibility of On-table Extubation After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Clinical Trial,” ANESTHESIOLOGY AND PAIN MEDICINE, vol. 8, no. 5, pp. 0–0, 2018, [Online]. Available: https://sid.ir/paper/772850/en

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