Show Summary Details
Page of

Anaesthesia for off-pump coronary artery bypass grafting 

Anaesthesia for off-pump coronary artery bypass grafting
Anaesthesia for off-pump coronary artery bypass grafting

Yatin Mehta

and Madhur Malik

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 19 October 2020

Despite the large increase in numbers of percutaneous coronary interventions, rates of coronary artery bypass graft (CABG) surgery are increasing around the world. Cardiopulmonary bypass (CPB) increases coagulopathy and bleeding, re-exploration, systemic inflammatory response syndrome, and possibly neurocognitive dysfunction and stroke. Off-pump CABG surgery (OPCAB) has evolved over the last two decades with the aim of reducing complications. OPCAB is technically more demanding than conventional CABG (cCABG) and also requires special instruments in order to accomplish coronary anastomosis on a moving target without significantly compromising haemodynamics. The anaesthetic goals during OPCAB include maintenance of stable haemodynamics by preload augmentation, poisitive inotropes and/or vasopressors and positioning of the patient. Good postoperative analgesia may include regional analgesic techniques such as thoracic epidural analgesia, intrathecal opioids, or paravertebral block so facilitating comfort and early mobilization and discharge. OPCAB has been shown to have equally good results as cCABG with reduced morbidity but not necessarily mortality.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.