What is the goal of optimal anesthesia care in CABG patients?
The goal of optimal anesthesia care in CABG patients is to prevent or minimize adverse hemodynamic and hormonal alterations that may induce myocardial ischemia or exert a deleterious effect on myocardial metabolism. This requires close interaction between the anesthesiologist and surgeon, particularly when manipulation of the heart or great vessels is likely to induce hemodynamic instability. During on-pump CABG, particular care is required during vascular cannulation and weaning from CPB; with off-pump CABG, the hemodynamic alterations often caused by displacement or verticalization of the heart and application of stabilizer devices on the epicardium, with resultant changes in heart rate, cardiac output, and systemic vascular resistance, should be monitored carefully and managed appropriately.