ANESTHESIA FOR CORONARY-ARTERY SURGERY

Anesthesia for coronary artery bypass graft surgery continues to evolv e in concert with changing epidemiology, advances in technology and ph armacology, and refinement in technique. The profile of the cardiac su rgical patient is increasingly characterized by factors such as advanc ed age, reoperation, combination procedures, complications of acute in tervention, and more complex disease. Preoperative risk factor assessm ent offers a means of strategic planning and intervention. Choice of a nesthetic agents, muscle relaxants, and anti-ischemic medications affe cts both perioperative management and long-term outcome. Transesophage al echocardiography and ST segment monitoring are being applied more b roadly. Advances have been made in managing postoperative blood loss. As in other areas of medicine, economic issues have become important c onsiderations in anesthesia for the cardiac surgical patient.