title: [Anesthetic management of concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy].
abstract: This case report describes an anesthetic management of a patient who received successful concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy. A 66-year-old man presented for left lower lobectomy. His medical history included angina pectoris under control with isosorbide and nifedipine. Preoperative coronary angiography revealed multiple stenosis [100% at right coronary artery (# 2), 99% at left anterodescending artery (# 7) and 90% at left circumflex artery (# 11)]. Concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy were scheduled. Anesthesia was maintained with combined total intravenous anesthesia (propofol and fentanyl) and continuous thoracic epidural anesthesia. Postoperative pain was well controlled with continuous epidural analgesia (TEA) and patient control analgesia (PCA). There were no signs of postoperative respiratory complications and myocardial ischemia. Combined total intravenous and continuous thoracic epidural anesthesia has multiple benefits for concomitant coronary artery bypass grafting without cardiopulmonary bypass and left lower lobectomy.
authors.affiliation: Department of Anesthesiology, Jichi Medical School, Tochigi.
authors.forename: M
authors.initials: M
authors.lastname: Satoh
authors.forename: Y
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: R
authors.initials: R
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000767:Anesthesia, Epidural; D000771:Anesthesia, Intravenous; D000787:Angina Pectoris / Q000150:complications / Q000601:surgery; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery; D008297:Male; D010149:Postoperative Pain / Q000628:therapy; D011013:Pneumonectomy