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Abstract
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Background and Aims Usage of the left internal mammary artery for coronary artery bypass grafting to the LAD is the gold standard due to better long term survival. We aimed to show the effects of anterior chest wall blocks on LIMA blood flow.
Methods The study included 135 patients was started after the approval of Van Yuzuncu Yil University Clinical Research Ethics Committee. ASA II-III cases with at least one LAD graft were randomized to PECS, SAP and control groups. After standard anesthesia induction while anterior chest wall blocks were not applied to the control group, 15cc bupivacaine was applied to the PECS I area and 15cc bupivacaine to the PECS II area in Group PECS, and 30cc bupivacaine was applied to the appropriate area in Group SAP. LIMA harvested, LIMA pedicle was sprayed with diluted papaverine. LIMA free flow was estimated by allowing the open distal end of LIMA to freely bleed into a small bowl for 20 s, measuring the amount of collected blood and the flow per minute was calculated accordingly. Results were evaluated with SPSS 27.0 program.
Results Demographic data were not statistically different between the groups (p>0.05) (table 1). LIMA blood flow was significantly higher in the SAP and PECS groups (p<0.05) (figure 1). The highest intubation-extubation interval was found in the C group (p<0.05) (figure 2).
Conclusions The results may be interpreted as an increase in LIMA graft quality, positive effects on patient survival and quality of life, and decreased cost to the patient and the healthcare system.
