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Korean J Anesthesiol > Volume 32(3); 1997 > Article
Korean Journal of Anesthesiology 1997;32(3):482-487.
DOI: https://doi.org/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.
Hyun Soo Moon, Sea Wook Sung, Jeong Moo Seo
1Department of Anesthesiology, SeJong General Hospital Puchon City, Korea.
2Department of Neurosurgery, College of Medicine, Dong-A University, Pusan, Korea.
3Department of Anesthesiology, Bando Hospital, Jinjoo, South Kyungsang, Korea.
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.
Key Words: Anesthetic techniques; induced hypotension; esmolol; verapamil; Surgery; coronary artery bypass grafting without bypass


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