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Eur J Cardiothorac Surg 2004;26:658-659
© 2004 Elsevier Science NL

Case report

Coronary artery bypass grafting in the awake patient: combined thoracic epidural and lumbar subarachnoid block

^a Casa di Cura Montevergine, Avellino, Italy
^b Bristol Heart Institute, University of Bristol, Bristol Royal Infirmary, Bristol, BS2 8HW, UK

Received 11 March 2004; received in revised form 10 May 2004; accepted 19 May 2004.

^* Corresponding author. Tel.: +44-117-928-3145; fax: +44-117-929-9737
e-mail: g.d.angelini{at}bristol.ac.uk

High thoracic epidural anaesthesia has recently been proposed to perform surgical revascularisation with arterial grafts in awake patients. However, in high-risk patients with associated co-morbidity it is not always possible to perform complete arterial revascularisation. A technique which combines thoracic epidural and selective lumbar subarachnoid block is described, allowing harvesting of saphenous vein and complete surgical revascularisation in awake patients.

Key Words: Off-pump • Thoracic epidural • Lumbar block

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