Which medications may be administered prior to coronary artery bypass grafting (CABG)?

Updated: Dec 04, 2019
  • Author: Rohit Shahani, MD, MS, MCh; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

The aims of premedication are to minimize myocardial oxygen demands by reducing heart rate and systemic arterial pressure and to improve myocardial blood flow with vasodilators. Drugs that should be continued up to the time of surgery are as follows:

  • Beta-blockers, calcium channel blockers, and nitrates

  • Aspirin

Administered agents are as follows:

  • Temazepam immediately preoperatively

  • Midazolam, a small intravenous (IV) dose in the operating room before arterial line insertion

Each patient should be cross-matched with 2 units of blood (for simple cases) or 6 units of blood, fresh frozen plasma, and platelets (for complex cases). [3, 6, 7] Tranexamic acid (1-g bolus before surgical incision followed by an infusion of 400 mg/hr during surgery) may be considered to reduce the amount of postoperative mediastinal bleeding and the quantity of blood products used (ie, red blood cell and fresh frozen plasma) [8]


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