Evolution and Perspectives of Anesthesia and Analgesia Techniques for Coronary Artery Bypass Grafting

For more than 60-year history of coronary artery bypass grafting, surgical techniques and specialists’ competence were improved as well as the safety of anesthesiological management. This analytical review discusses modern features of analgesia during coronary surgery and early postoperative period. We described current opinion on perioperative administration of opioids and modern methods of analgesia, taking into account possible complications of their use. Despite the low mortality and overall safety of coronary bypass grafting nowadays, the optimal strategy of analgesia for this surgery is not established yet. This review lists routinely used analgetics and some aspects of their use in cardiac anesthesiology, outlines trends and prospects for the introduction of new drugs and techniques for analgesia. Despite a number of restrictions on the use of opioids in intensive care in modern era, in cardiac anesthesiology their use remains justified and, under certain conditions, safe enough.