Year : 2019  |  Volume : 13  |  Issue : 1  |  Page : 14-18

Off-pump coronary artery grafting in awake patients with comorbidities using high thoracic epidural anesthesia

1 Department of Cardiothoracic Surgery, Cairo University, Giza, Egypt
2 Department of Anaesthesia, Cairo University, Giza, Egypt

Correspondence Address:
Ahmed S Mahmoud
MD Cardiothoracic Surgery, Lecturer of Cardiothoracic Surgery, Cairo University, 12654
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejca.ejca_16_18

Rights and Permissions

Background General anesthesia (GA) can be itself an obstacle to some patients with comorbidities to operate upon a mandatory cardiac surgery. Patients and methods Between January 2013 and May 2017 in the Cardiothoracic Surgery Department, Cairo University Hospitals; 31 patients of awake ‘off-pump’ (without cardiopulmonary bypass) coronary bypass surgery were performed by sternotomy, facilitated by thoracic epidural anesthesia. Analgesia was provided with thoracic epidural anesthesia at T2–3 interspace, using bupivacaine 0.5%, lidocaine 2%, and fentanyl 2 μg/ml until T1–8 dermatomal block was achieved, and then was maintained at 8–12 ml/h throughout the surgery. Success of awake off-pump coronary artery bypass grafting, without GA with appropriate surgical and medical conditions, was the target of the study. Results Thirty-one patients (range, 50–70 years) median, 61 years, weight (range, 70–109 kg) median, 78 kg, underwent surgery. Five (16%) patients needed conversion to GA: the left internal mammary artery was dissected, a saphenous vein graft was needed instead. Awake surgery was successful without complications in 68% of cases. Conclusions Off-pump coronary artery bypass grafting in awake old patients can be considered a safe and feasible technique with convenient surgical outcome especially in patients who cannot tolerate GA.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded54    
    Comments [Add]    

Recommend this journal