Is extubating my cardiac surgery patient postoperatively in the operating room a good idea?

Abstract

Following multiple episodes of shortness of breath at home, a 66-year-old man with severe mitral regurgitation undergoes an elective mitral valve repair via mini-thoracotomy. His past medical history is significant for diabetes controlled with metformin and hypertension treated with metoprolol. In the past, he was a casual tennis player, but lately he has been feeling short of breath going up the flight of stairs in his house. It is the first case of the day. Induction, intubation, and line placement are uneventful, and the surgery proceeds without incident. At the end of the case, the surgeon jokes to his assistant, "This gas man over here has the easiest job; he just hits every patient over the head with his cookbook and hopes they wake up some point later in the day."