Routine immediate extubation after off-pump coronary artery bypass surgery: 514 consecutive patients

Objective: The purpose of this study was to evaluate the feasibility of routine immediate extubation in patients undergoing off-pump coronary artery bypass surgery. Design: Case series. Setting: Private hospital. Participants: Five hundred forty-eight consecutive patients undergoing off-pump coronary bypass surgery, representing 5 years of a single anesthesiologist's practice, were evaluated for routine immediate extubation. Thirty-four patients were excluded because they were already intubated, in preoperative cardiogenic shock, or converted to on-pump during the procedure. Intervention: Patients received general anesthesia or general anesthesia plus thoracic epidural analgesia (25%) and underwent off-pump coronary bypass surgery. Measurements and Main Results: All 514 patients who were intended to be immediately extubated were expeditiously extubated in the operating room. The numbers of reintubations, morbidity, and mortality were low. Conclusions: Routine immediate extubation of most off-pump coronary artery bypass patients appears feasible and most probably safe. (c) 2005 Elsevier Inc. All rights reserved.