[Early cessation of artificial ventilation of the lungs (extubation of the trachea in the operating room) in patients undergoing surgery with artificial circulation]

Abstract

Forty-nine patients operated on the open heart under combined total anesthesia with nitrogen oxide, enflurane or isoflurane and propofol (group 1) and 22 ones anesthesized with high fentanyl doses (group 2) were examined. To group 1 patients fentanyl and pancuronium bromide were injected only in the preperfusion period of the operation. Early extubation was carried out in 44 (90%) group 1 patients. The duration of postoperative artificial ventilation of the lungs was 102 +/- 15 min in group 1 and 16 +/- 1 h in group 2. No grave postoperative complications or early mortality were recorded. In the morning of the first postoperative 24 h 7% of group 1 patients and 41% of group 2 ones were administered inotropic therapy (p < 0.05). Duration of stay in resuscitation ward was 0.96 +/- 0.05 days in group 1 and 2.04 +/- 0.09 days in group 2 (p < 0.01). The authors come to a conclusion on the desirability of early extubation after open-heart surgery. Indications for and contraindications against early extubation are discussed.