Dr. Saiful Islam Azad ,working as Cardiac anaesthesiologist since 2003 at National Institute of Cardiovascular Diseases and Hospital,Dhaka, Bangladesh. Obtained MD (Anaesthesiology)from Dhaka University in 2009 , Fellow in pediatric Cardiac anaesthesia ,Delhi, India, Fellow in Pain Management and regional anaesthesia,Delhi, India.

The common challenges for the cardiac anaesthesiologist during off pump coronary artery by pass surgery (OPCAB) include haemodynamic stability during the different stressful surgical events and multiple cardiac manipulations,providing adequate myocardial protection and obtaining minimum pharmacological intervention with effective postoperative analgesia leading to early discharge from the ICU with high satisfaction level. A combined high thoracic epidural anaesthesia with GA is safe and more efficient in providing overall cardiovascular stability as well as improving the parameters leading to a better outcome in terms of a shorter and more predictable road map to recovery. Sixty patients aged within 40-70years,scheduled for CABG on beating heart were enrolled in prospective, randomized observational comparative study. Group A patient receive GA alone and group B patient received high thoracic epidural anaesthesia with GA. Significant heart rate changes during different events of operation,no incidence of different arrhythmia occurred in group B. Requirement of cardiac drugs significantly reduced in group B.The data were compiled and analyzed by using SPSS(ver.12.0).