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SOP » Anaesthesia protocol » Introduction
Last modified on Tue 15 Jul 2014

Two forces have driven cardiac surgeons to explore new approaches for coronary artery surgery. The first is a socioeconomic force: it is ubiquitous in medicine but applies particularly to the field of CABG surgery because this intervention, although beneficial, is costly to the community. The second is of a competitive nature: the development of interventional cardiology with PTCA and stenting of coronary arteries has offered elegant and less invasive alternatives to surgery for a large percentage of patients with ischemic heart disease. In order to compete with these therapies CABG ought to become less costly and less invasive without losing its advantageous excellent long-term results. It is expected that the elimination of CPB will help to achieve this goal, i.e. by reducing the immediate risk of vital organ damage due to embolism/thrombosis and inflammation.

Unlike traditional CABG where the anesthesiologist plays a rather passive role during the performance of bypass grafting, active involvement of the anesthesia team is essential for successful OPCAB.

OPCAB cases require vigilant anticipation of surgical steps, skilled hemodynamic management and close communication with the cardiothoracic surgeon. Prevention as well as treatment of myocardial ischemia and reperfusion injury are important objectives.
The goal of this report is to give a summary of anesthetic techniques that we use in our institute for off-pump coronary artery bypass (OPCAB) surgery.