[Method of anesthesia and perioperative management for off-pump coronary artery bypass grafting]

To investigate the method of anesthesia and perioperative management for off- pump coronary artery bypass grafting (OPCABG), and to examine the hemodynamic changes during the operation.

One hundred and thirteen patients undergoing OPCABG were studied. Anesthesia induction was achieved by giving midazolam 0.05 mg/kg, ketamine 0.5 mg/kg, vecuronium 0.13-0.15 mg/kg and fentanyl 5-10 microg/kg. Vecuronium and fentanyl were given as needed, isoflurane and propofol were administered for maintenance. Hemodynamic indexes, ST-segment change in electrocardiogram (ECG) and lidocaine's influence to the cardiac rhythm were observed and recorded during the main process of operation.

Observation before and during the operation showed that mean arterial pressure (MAP) and heart rate (HR) decreased a little but within clinical acceptable range, at the beginning, and it recovered soon. The result of rate-pressure product (RPP) showed that the reduction of cardiac muscle oxygen consumption was satisfactory. There was no significant change in ST-segment in ECG (P>0.05) before and during the main procedure. Giving 1 mg/kg lidocaine before the operation could obviously lower the possibility or degree of premature ventricular extrasystole.

OPCABG can be performed safely under the above method of anesthesia. The perioperative management is effective and satisfactory in maintaining stable circulation and in keeping oxygen supply and consumption balance.