Tham Shu Qi, Lim Evangeline H L
Department of Pediatric Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore.
Anaesthesiology and Perioperative Sciences Academic Clinical Program (Duke-NUS), Singapore, Singapore.
Anesth Pain Med (Seoul). 2024 Oct;19(Suppl 1):S61-S72. doi: 10.17085/apm.23154. Epub 2024 Jul 24.
Early extubation after pediatric cardiac surgery has come full circle from being practiced in the early days of pediatric cardiac surgery, falling out of favor with opioid-heavy cardiostable anesthesia, and resurfacing again in more recent times as part of enhanced recovery after surgery practice. Early extubation is variably defined, but is mostly accepted as extubation that occurs within 6-8 h from the end of surgery. In recent years, the debate has shifted from early extubation in the intensive care unit to immediate extubation in the operating theatre. In this review, we examined the benefits and pitfalls of early and immediate extubation, factors that influence the success of early extubation, and potential guidelines for practice and implementation.
小儿心脏手术后的早期拔管经历了一个轮回，从小儿心脏手术早期就开始实施，后来因使用大量阿片类药物的心脏稳定麻醉而失宠，最近又作为术后加速康复实践的一部分再次出现。早期拔管的定义各不相同，但大多被认为是在手术结束后6 - 8小时内进行的拔管。近年来，争论已从重症监护病房的早期拔管转向手术室的即时拔管。在本综述中，我们探讨了早期和即时拔管的益处与弊端、影响早期拔管成功的因素以及实践和实施的潜在指南。
