Thoracic Epidural Anesthesia as the Last Option for Treating Angina in a Patient Before Coronary Artery Bypass Surgery

1 patient (68-year-old man) with ischemic cardiomyopathy, medically refractory unstable angina, poor ventricular function (EF 20%), and complicated comorbidities (hypertension, peripheral vascular disease, prior cerebrovascular accident, prior pacemaker, acute tubular necrosis on chronic renal insufficiency).

Thoracic epidural anesthesia (TEA) using bupivacaine and morphine (initial 5-mL bolus of 0.25% bupivacaine, followed by continuous infusion of 0.0625% bupivacaine with 100 µg/mL morphine at 4 mL/h), continued intraoperatively and postoperatively during 4-vessel CABG surgery.

Relief of angina symptoms and hemodynamic stabilization prior to and during CABG surgerypatient reported