Clinical Study On Anesthesia Of Coronary Artery Bypass Grafting (CABG) Surgery

Part Ⅰ : Anesthetic Management and Early Outcome of aRandomized Comparison of On-Pump and Off-Pump Coronary Artery Bypass GraftingObjective: To compare the anaesthetic management and early outcome of both on-pump and off-pump CABG in a prospective randomized controlled trial. Method: 131 consecutive unselected patients referred for elective primary CABG were randomly assigned to accept either on-pump (n=45) or off-pump (n=86) CABG. The anaesthetic management and clinical outcomes were compared. Result: The operation time in off-pump group was significantly shorter than that in on-pump group (244±47min Vs 312±59min) (P<0.05). The bleeding and frequency of need for blood or blood products transfusion was higher in on-pump group compared with off-pump group (P<0.05). The number of grafts performed per patient (2.7±0.6 for off-pump CABG and 2.9±0.7 for on-pump CABG) were similar. There were no hospital deaths in either group. The incidence of perioperative complications in off-pump group was significantly lesser than that in the on-pump group (P<0.05). Postoperative serum CK-MB levels increased above normal value in the two groups, but it was more pronounced in on-pump group (P<0.05). Conclusions: OPCAB with multiple arterial grafts is as safe as CABG. The incidence of perioperative complications and the postoperative recovery of off-pump group is more satisfactory than that of on-pump group.