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The study was supported by the Nova Scotia Heart Foundation and Ohio Medical Anesthetics.Maintenance of myocardial oxygen balance during anaesthesia is essential, particularly for patients with coronary artery disease, to avoid major ischaemic episodes or frank infarction. Increased oxygen consumption due to a hyperdynamic circulation must be avoided. Moderate depression of myocardial contractility by potent anaesthetic drugs is desirable but must be controllable. The adequacy of myocardial oxygenation can now be assessed in the operating room, by measuring coronary sinus blood flow, myocardial oxygen consumption and lactate extraction. Myocardial oxygenation can be maintained in coronary patients with halothaneoxygen but not so with 1 mg.kg -l of morphine, and oxygen. ~ Delaney et al. 2 reported, in patients having coronary vein grafts (CABG), myocardial function and haemodynamic effects of enflurane, but correlation of haemodynamics with CBF, MVO2 and MLE has not been documented. We present the haemodynamic and myocardial metabolic effects of enflurane-oxygen anaesthesia from pre-induction, through anaesthesia and operation for CABG and for 24 hours afterward. Methods Study populationTen male patients gave their informed consent. Mean age was 53.7 years (range 34-62), mean weight 79.2 Kg (68-91); eight had known previous infarction. Their disability by NYHA Class was: 11 -one patient, III -seven and IV -two; all patients were normotensive. Nine were kept on effective beta blockade (average: propranolol dose 40rag q.i.d.) until operation. Although nine had signi-CAN ANAESTH SOC ] 1984 ! 31:6 I pp604-10

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