Abstract

Fasttrack extubation following coronary artery bypass surgery facilitates fast recovery and discharge from the Intensive Care Unit (ICU). It has shown to decrease the expenditure of expensive resources and is safe with better pulmonary functions. Aims & Objectives :To determine if implementation of fasttrack extubation protocol in Off Pump CABG has any benefit on analgesic requirement and postoperative outcomes. Materials and Methods: 100 patients undergoing elective off pump coronary artery bypass graft repair in the period of last 3 years were included in the study. The fast track group patients were extubated within 6hrs, while the other group was extubated within 12 to 24 hrs after surgery. Postoperative analgesia was by inj. Tramadol 2mg/kg and inj. Paracetamol 20mg/kg iv 8 hourly for the next 24 hours. IV morphine 0.05mg/kg was administered as rescue analgesia when VAS at rest was ≥ 4 (max dose allowed in 24 hour was 10 mg).After 20 min. of extubation ABG was done . Pain was assessed according to VAS score and recorded at 20 min,1,6, 12, 18, and 24 hrs post extubation. Results: Demographic data were similar among the two groups.Total consumption of morphine as rescue analgesia in 24 hrs in group A was (2.77 ± 1.19mg) while in group B it was (3.05 ± 1.11 mg), which was statistically insignificant. Mean duration of hospital stay (in days) in group A was (6.10 ± 0.89) while in group B it was (9.84 ± 1.36) which was statistically highly significant(p<0.001).1 patient in each group had nausea and vomiting and 1 patient in group B needed ionotropic support. Conclusion: Implementation of fasttrack extubation reduced the duration of hospital stay but there were no difference in analgesic requirement or in immediate postoperative complications

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