Anaesthetic implications during off-pump coronary artery bypass surgery

Off-pump coronary artery bypass has emerged as a popular method of coronary revascularization to mitigate the harmful effects of cardiopulmonary bypass. It requires surgical and anaesthetic expertise for good results. Newer minimally invasive approaches to off pump coronary bypass provide attractive alternatives to conventional off pump surgery, especially in achieving better cosmetic results and early extubation. They require good perioperative pain management, with epidural and paravertebral block being good choices. Emergency conversion of off-pump bypass to on-pump bypass is associated with poor outcomes, so preventive measures to avoid it should be employed. Keywords: Off-pump coronary artery bypass, Anaesthetic implications.