[The anesthetic management of patients in chronic renal failure for coronary artery bypass surgery without cardiopulmonary bypass].

We describe our experience with three patients in chronic renal failure who underwent coronary artery bypass surgery without cardiopulmonary bypass. Anesthesia was maintained with fentanyl and midazolam. Nitroglycerin and prostaglandin E1 were administered during the surgical procedure. When the coronary artery was clamped for the anastomosis of the graft, cardiac output and arterial pressure decreased in all cases. The patients were treated with ephedrine and dobutamine, which restored the hemodynamics. The important points for the anesthetic management for this operation are follows: the adequate administration of the coronary vasodilator, and attention to the change of hemodynamics on clamping the coronary artery.