Use of neuraxial agents in anesthesia for cardiac surgery is expanding. We have used combined general-spinal anesthesia for cardiac surgery for 12 years. We hypothesized that compared to general anesthesia, the combined techniques would provide comparable intraoperative hemodynamics and improved postoperative analgesia. This study subjected these techniques to a double-blind randomized trial.
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Inclusion Criteria: * patients undergoing non-emergent primary coronary artery bypass grafting using cardiopulmonary bypass Exclusion Criteria: * \< 25 or \> 80 years of age * left ventricular ejection fraction \< 35% * receiving inotropic or intraaortic balloon therapy at time of surgery * receiving intravenous heparin therapy at time of surgery * pre-existing back problems in the lumbar area * clinical or laboratory evidence of coagulopathy