Cor Vasa 2002, 43(4):197-199

"Fast track" anesthesia-standard for less invasive procedures in cardiac surgery

Zbyněk Straka^*, Petr Brůček, Tomáš Vaněk: Kardiocentrum Fakultní nemocnice Královské Vinohrady a 3. lékařské fakulty Univerzity Karlovy, Praha, Česká republika

Introduction:
The explosion of less invasive cardiac surgery, mainly in the field of coronary reconstruction without cardiopulmonary bypass (CPB), has led to the development of a new procedure, referred to as fast-track anesthesia, allowing extubation of the patient while still in the operating theater. The techniques described to date combined with endotracheal general anesthesia with thoracic epidural analgesia.

Patients and methods:
"Fast-track" anesthesia using an ultra-short-acting opiate without epidural catheter insertion was induced in 114 patients undergoing surgery for CHD without the use of extracorporeal circulation (EC).

Results:
Extubation in the operating theater within 10 minutes of completion of surgery was possible in 108 (95%). Four patients were converted to standard anesthesia. There was no death during hospitalization, and the rates of major postoperative complications were low.

Conclusions:
Based on their results, the authors consider "fast-track" anesthesia a safe and promising technique of anesthesia in cardiac surgery.