Post coronary artery bypass graft surgery

Fast track method in cardiac surgery: evaluation of risks and
benefits
Najafi M, Soleimanzadeh M and Haghighat B
Tehran Heart Center, Medical Sciences/University of Tehran, Tehran, Iran
Abstract
Background: Fast Track (FT) method is recommended for accelerating the recovery
phase, but it may not work because of some respiratory complications. This study
compares the routine and FT method for managing post CABG patients in Intensive
Care Unit (ICU).
Methods: One hundred cases were divided into two groups. In FT group, fentanyl
(0.05-0.15 Pg/kg/min) and Propofol (10-50 Pg/kg/min) infusions were started since
induction time. Atracurium infusion started one hour later, no bolus drug was
administered during operation. Muscle relaxants were neutralized at the end of surgery.
Fentanyl infusion continued up to 12 hours post surgery. The above two groups were
evaluated for time of alertness and extubation in ICU, total analgesic dosage
administered during 24 hours post operation, ABG and SpO2 pre-and post-extubation.
Inclusion and exclusion criteria for FT method as well as extubation criteria were
explained to the ICU, staff.
Results: Time period between ICU admition and alertness was significantly different in
FT (1.3 hour) and control group (3.3 hours) (P