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Spinal Anesthesia Increases the Frequency of Extubation in the Operating Room and Decreases the Time of Mechanical Ventilation after Cardiac Surgery

2020; Brazilian Society of Cardiovascular Surgery; Volume: 36; Issue: 1 Linguagem: Inglês

10.21470/1678-9741-2019-0433

1678-9741

Gustavo Siqueira Elmiro, Artur Henrique de Souza, Stanlley de Oliveira Loyola, Maurício Prudente, Celina Lumi Kushida, José Onofre de Carvalho Sobrinho, Fabiano Zumpano, Giulliano Gardenghi,

Anesthesia and Neurotoxicity Research

Introduction: The delayed extubation of patients undergoing mechanical ventilation (MV) in the postoperative period of cardiac surgery (CS) is associated with mortality.The adoption of spinal anesthesia (SA) combined with general anesthesia in CS influences the orotracheal intubation time (OIT).This study aims to verify if the adoption of SA reduces the time of MV after CS, compared to general anesthesia (GA) alone.Methods: Two hundred and seventeen CS patients were divided into two groups.The GA group included 108 patients (age: 56±1 years, 66 males) and the SA group included 109 patients (age: 60±13 years, 55 males).Patients were weaned from MV and, after clinical evaluation, extubated.Results: In the SA group, considering a 13-month period, 24% of the patients were extubated in the operating room (OR), compared to 10% in the GA group (P=0.00).The OIT was lower in the SA group than in the GA group (SA: 4.4±5.9hours vs. GA: 6.0±5.6 hours, P=0.04).In July/2017, where all surgeries were performed in the GA regimen, only 7.1% of the patients were extubated in the OR.In July/2018, 94% of the surgeries were performed under SA, and 64.7% of the patients were extubated in the OR (P=0.00).The OIT on arrival at the intensive care unit to extubation, comparing July/2017 to July/2018, was 5.3±5.3 hours in the GA group vs. 1.7±3.9hours in the SA group (P=0.04). Conclusion:The adoption of SA in CS increased the frequency of extubations in the OR and decreased OIT and MV time.