Korean J Anesthesiol.  1997 Mar;32(3):482-487. 10.4097/kjae.1997.32.3.482.

Induced Hypotension And Bradycardia During General Anesthesia For Coronaray Artery Bypass Graft Without Cardiopulmonary Bypass: A case report

• Moon HS
• Sung SW
• Seo JM

• KMID: 2033340
• DOI: http://doi.org/10.4097/kjae.1997.32.3.482

Abstract

Coronary artery bypass grafting(CABG) without cardiopulmonary bypass is now an accepted technique of myocardial revasculization in terms of preventive method from various complications of cardiopulmonary bypass. Despite danger of myocardial ischemia, induced hypotension with bradycardia are sometimes necessary for the convenience of operative approach to beating heart. We report a case of induced hypotension with bradycardia during general anesthesia for CABG without cardiopulmonary bypass. After induction and maintenance of balanced anesthesia with fentanyl-midazolam-isofluranepiperocuronium for the 68 kg, 55 years old male stable angina patient, we induced controlled hypotension(systolic blood pressure: 70~80 mmHg) and bradycardia(heart rate: 50~60/min.) by bolus injections of verapamil 5 mg and esmolol 30 mg followed by continuous infusion of esmolol 0.1~0.3 mg/kg/min. during 50 minutes of main graft implantations without bypass. Any significant ischemic changes on EKG were not detected during induced hypotension and bradycardia. Patient was recovered without any signs of myocardial ischemia postoperativery and discharged 8 days after operation.

Keyword

Anesthetic techniques; induced hypotension; esmolol; verapamil; Surgery; coronary artery bypass grafting without bypass

MeSH Terms

Anesthesia, General*
Angina, Stable
Arteries*
Balanced Anesthesia
Blood Pressure
Bradycardia*
Cardiopulmonary Bypass*
Coronary Artery Bypass
Electrocardiography
Heart
Humans
Hypotension*
Male
Middle Aged
Myocardial Ischemia
Transplants*
Verapamil
Verapamil