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Background and Aims he anesthesia management of coronary patients is marked by the perioperative challenges of platelet aggregation inhibitors and post-operative pain management, which could lead to ischemic complications. This case involves a coronary patient undergoing surgery for an axillary tumor.

Methods A 49-year-old coronary patient, K. Zahia, with a history of myocardial infarction less than a year ago, presented with left axillary tumor complicated by brachial neuropathy. Pre-anesthetic evaluation revealed ischemic cardiopathy on electrical and echocardiographic examination. Anesthetic Preparation: Discontinuation of Plavix for 7 days and Triatec for 24 hours preoperatively. Premedication with hydroxyzine. Monitoring included ECG, pulse oximetry, end-tidal CO2, and troponin levels. Technical Anesthesia: Regional anesthesia (RA) combined with general anesthesia (GA). Left supraclavicular block (SCB) followed by continuous paravertebral block (CPVB) at T3-T4 level. GA induction with Diprivan, Vecuronium, and Fentanyl, followed by maintenance anesthesia with Diprivan. The CPVB catheter provided postoperative analgesia.

Results Coronary patient anesthesia requires hemodynamic stability and adequate analgesia to prevent ischemic complications. The combination of GA and RA offers effective pain management and facilitates early rehabilitation.

Conclusions Optimal coronary patient anesthesia aims for hemodynamic stability and perioperative analgesia to prevent ischemic complications. The combination of GA and RA achieves these goals effectively, promoting early rehabilitation and reducing postoperative morbidity.