Pro: Tracheal extubation should occur routinely in the operating room after cardiac surgery

Lee, Trevor W.R.; Jacobsohn, Eric

doi:10.1053/jcan.2000.9498

Cited by 40 publications

(9 citation statements)

References 39 publications

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“…Early tracheal extubation is a desirable goal for cardiac surgical patients and may lead to better respiratory function and decreased cost and length of ICU stay [11]- [13]. To achieve this goal, the immediate postoperative period is the crucial time to establish stable hemodynamics, alert mental status, and adequate pain control.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Parasternal Intercostal Block Using Ropivacaine or bupivacaine for Postoperative Analgesia in Patients Undergoing Cardiac Surgery

Saini¹,

Chauhan²,

Kiran³

et al. 2015

WJCS

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Objective: The objective of this study was to compare the efficacy of 0.5% ropivacaine and 0.25% bupivacaine for parasternal intercostal block for postoperative analgesia in children undergoing cardiac surgery. Design: A randomized, controlled, prospective, double blind study. Setting: A tertiary care teaching hospital. Participants: One Hundred children scheduled for cardiac surgery through a median sternotomy were divided into 3 groups of at least 33 children each, receiving either ropivacaine, bupivacaine or saline (control). Interventions: A bilateral parasternal block performed either with 0.5% ropivacaine or 0.25% bupiacaine or 0.9% saline with 5 doses of 0.5 mL on each side in the 2nd to 6th parasternal intercostal spaces 1 to 1.5 cm lateral to the sternal edge, before sternal wound closure. Measurements and Main Results: The time to extubation was significantly less in children administered the parasternal blocks with ropivacaine or bupivacaine compared to the saline (control) group. The pain scores were lower and comparable in the ropivacaine and bupivacaine groups compared to the saline group. The cumulative fentanyl dose requirement over a 24-hour period was higher in the saline group than the ropivacaine (p < 0.001) and bupivacaine group. No side effects were observed in any of the children. Conclusions: Parasternal blocks either with ropivacaine or bupivacaine appear to be a simple, safe, and useful technique for supplementation of postoperative analgesia in children undergoing cardiac surgery with a median sternotomy.

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Section: Discussionmentioning

confidence: 99%

Comparison of Parasternal Intercostal Block Using Ropivacaine or bupivacaine for Postoperative Analgesia in Patients Undergoing Cardiac Surgery

Saini¹,

Chauhan²,

Kiran³

et al. 2015

WJCS

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“…(41) There are several studies on outcome after extubation in the operation room, which show that it is feasible with good results. (42,43) However, the nadir of ventricular function occurs about 4 hours following cardiopulmonary bypass. Also, the first few hours after cardiac surgery are characterized by periods of haemodynamic instability, temperature dysregulation, increased mediastinal blood loss and other homeostatic disturbances.…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Early Postoperative Care After Cardiac Surgery

Roekaerts¹,

Heijmans²

2012

Perioperative Considerations in Cardiac Surgery

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“…Today, debates about the optimal time of extubaion after heart surgery are still ongoing (Roekaerts & Heijmans, 2012). Despite the fact that studies show that extubation in the operating room is well done, rapid changes in hemodynamic instability, changes in body temperature, mediastinal blood and fluid loss and other hemostatic disorders are expected in the first few hours postoperatively (Lee & Jacobsohn, 2000;Djaiani et al, 2001;Roekaerts & Heijmans, 2012, Rodriguez-Blanco et al, 2012, Garg et al, 2014Hamilton et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Intraoperative variables associated with extubation time in patients undergoing open heart surgery

İbrahimoğlu¹

2017

PROSOC

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Decreasing mechanical ventilation and early extubation in patients has many clinical benefits. Hence, an awareness of some variables, associated with extubation time can help nurses to plan convenient care aimed at making a safe and early extubation. The purpose of this study was to investigate whether any intraoperative variables had a significant effect on extubation time following open heart surgery. The research was conducted on 60 open heart surgery patients who met inclusion criteria between April 2014 and November 2014 in a cardiac and vasculer surgery clinic of university hospital in Istanbul, Turkey. The data were collected by using a "Questionnaire Form" which includes some intraoperative variables (type of surgery, the number of grafts, the duration of time of the cardiopulmonary bypass, aortic crossclamping, total operation time, and the extubation time). The data was analyzed by descriptive and analytical methods. Type of the surgery procedure was 40 (66%) patients were CABG, 10 (16,6%) were valvuler surgery, 6 (10%) were ASD/VSD primer repair and 4 (3,3%) were Bentall procedure. Extubation was achieved for 60 patients in a mean time of 8.33±1.99 h. 18,3% (11) of the patients were extubated in ≤6 h and 81,7% (49) of them were extubated in >6 h after surgery, classifying them into the early and delayed extubation groups, respectively. On statistical analysis, the duration of the cardiopulmonary bypass (CPB) and aortic cross-clamping were found to have a significant effect on the extubation time.This study revealed that the duration of the cardiopulmonary bypass and aortic cross-clamping might play a role in the extubation time. Therefore, it is recommended that nurses consider this in their assessment of extubation as a shorter cardiopulmonary bypass time and aortic cross-clamping time might lead to earlier extubation.

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Pro: Tracheal extubation should occur routinely in the operating room after cardiac surgery

Cited by 40 publications

References 39 publications

Comparison of Parasternal Intercostal Block Using Ropivacaine or bupivacaine for Postoperative Analgesia in Patients Undergoing Cardiac Surgery

Comparison of Parasternal Intercostal Block Using Ropivacaine or bupivacaine for Postoperative Analgesia in Patients Undergoing Cardiac Surgery

Early Postoperative Care After Cardiac Surgery

Intraoperative variables associated with extubation time in patients undergoing open heart surgery

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