Korean J Anesthesiol.  2000 Nov;39(5):766-771. 10.4097/kjae.2000.39.5.766.

Beating Heart CABG under Thoracic Epidural Block Combined with Light General Anesthesia in Renal Transplanted Patient

• Kim KH
• Park KH
• Lee EK

• KMID: 2031649
• DOI: http://doi.org/10.4097/kjae.2000.39.5.766

Abstract

Beating heart CABG is defined as a CABG without cardiopulmonary bypass (CPB). Therefore there are no complications associated with CPB. So it is possible to extubate simultaneously with the end of the operation, and also it is effective to reduce the ICU time and the cost. Our team performed a beating heart CABG on a patient who had a history of renal transplantation, to avoid the renal complication due to CPB. We chose the thoracic epidural block combined with light general anesthesia as an anesthetic technique. We managed the patient successfully with consistent hemodynamic stability without the need of any drugs to induce bradycardia. We returned the patient to consciousness before extubation and extubated concurrently with the end of the operation. The patient maintained stable hemodynamics throughout the postoperative period, especially during the ICU stay and we controlled the pain via an epidural catheter with morphine and 0.125% bupivacaine for 3 days. The patient stayed in ICU only one day and was mobile on the second postoperative day. The patient was discharged without any complications, especially renal.

Keyword

Anesthetic technique: epidural; thoracic; Heart: cardiopulmonary bypass; coronary artery disease; Surgery: coronary artery bypass graft

MeSH Terms

Anesthesia, General*
Bradycardia
Bupivacaine
Cardiopulmonary Bypass
Catheters
Consciousness
Heart*
Hemodynamics
Humans
Kidney Transplantation
Morphine
Postoperative Period
Bupivacaine
Morphine