Objective: To assess the safety of early (<2 hrs) extubation after elective infrarenal aortic surgical procedures.
Design: A retrospective chart review of 192 consecutive elective infrarenal aortic surgical procedures from January 1990 to March 1994 at Mayo Clinic Scottsdale was undertaken.
Measurements and main results: Combined general and epidural anesthesia was used extensively (187 patients; 97.4%). Early extubation was accomplished in 166 (86.5%) patients. Time to extubation was dependent on clinical factors and not by protocol. All early extubations occurred in the operating room or recovery room with a median time from skin closure of 12 minutes. Ten patients were extubated from 2 to 12 hours after the procedure, 14 patients more than 12 hours after the procedure, and 2 patients were not extubated and subsequently expired. Of the 166 patients extubated within 2 hours, 8 (4.8%) required reintubation. Factors found univariantly to be significantly associated with failure of early extubation include obesity, abnormal chest x-ray postoperatively, prior myocardial infarction, and prior coronary revascularization (p < 0.05).
Conclusion: Early extubation (<2 hrs) after elective infrarenal aortic procedures may be performed safely and should be undertaken unless clinical features suggest failure of extubation.