Anesthetic management with halothane or enflurane and adjuvant agents is effective in minimizing increases in myocardial oxygen demand in the majority of patients undergoing coronary artery bypass (CABG). Transient elevations of myocardial oxygen demand as evidenced by violations of mean and range of threshold TRPP during intubation do not result in myocardial damage as detected by EKG and creatine phosphokinase isoenzyme MB enzyme methods. Sustained elevations of myocardial oxygen consumption, deficiencies in myocardial oxygen supply, inadequate myocardial preservation during bypass and incomplete revascularization remain potential sources of ischemic myocardial damage during CABG.
