Routine immediate extubation after cardiac operation: A review of our first 100 patients

Abstract

Background. Early extubation after cardiac operation is an important aspect of fast-track cardiac anesthesia. Immediate extubation is an extension of this concept. We describe a technique that allows immediate extubation in the majority of patients. Methods. To allow rapid emergence, anesthesia was modified from a high-dose opioid technique to intravenous propofol anesthesia supplemented with sevoflurane. Normothermic cardiopulmonary bypass was used with routine intermittent antegrade and retrograde tepid blood cardioplegia. High thoracic epidural analgesia was used to facilitate immediate extubation in the majority of patients. Contraindications to immediate extubation were prolonged cardio..