Introduction: Although it has been demonstrated that early tracheal extubation in cardiac anesthesia is safe and cost beneficial [1], questions still remain regarding how early should cardiac surgery patients be extubated. The objective of this study is to determine the effects on resource use if patients scheduled for CABG are extubated in the operating room. Methods: After institutional approval and informed consent, 90 consecutive patients undergoing elective CABG, requiring extracorporeal circulation and eligible for a fast track cardiac surgery pathway were studied. Anesthetic induction consisted of fentanyl 5-15 upsilon g/kg, thiopental 4-6 mg/kg and pancuronium 0,1 mg/kg followed by maintenance with inhalational agents. Upon rewarming an analgesic/sedative infusion of fentanyl was initiated. At the end of procedure the muscle relaxants were reverted and the patients extubated if they were hemodynamically stable, without significant bleeding and fulfill clinical and blood gases parameters [2]. Patients who did not completed the requirements were extubated in the postoperative ICU. Time in the operating room after skin closure, ICU length of stay (LOS), postoperative LOS and rate of re-intubation were collected and analyzed by unpaired t-test, one-way ANOVA or Chi square as appropriate. Results: Demographic data were comparable between the 2 groups. Forty-eight patients were extubated in the operating room. Four patients in the group extubated in the operating room were re-intubated secondary to respiratory depression and ventilated for 2-4 hours. One of these patients had a postoperative MI (myocardial infarction) with an unenventful recovery. No deaths occurred in any group (Table 1). ICU and POP LOS were similar between the groups (Table 2).Table 1Table 2Discussion: Our preliminary data demonstrate that tracheal extubation in the operating room after CABG is safe, but a moderate rate of re-intubation should be expected. Although the incidence of MI was higher in the OR group, the sample size in this study does not allow us to prove a significant higher risk in that group. In our experience this practice does not increase the time in the operating room. Extubation in the operating Table is not associated with significantly decreased ICU and postoperative LOS.