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Cardiac risk reduction in non-cardiac surgery: the role of anaesthesia and monitoring techniques

Gal, J.*; Bogar, L.; Acsady, G.*; Kertai, M. D.*

European Journal of Anaesthesiology (EJA): August 2006 - Volume 23 - Issue 8 - p 641-648
doi: 10.1017/S0265021506000640

Cardiac complications are the major cause of perioperative morbidity and mortality of patients undergoing non-cardiac surgery. This is related to the frequent presence of underlying coronary artery disease. In the last few decades, attention has focused on preoperative cardiac risk assessment that may help to identify patients at increased cardiac risk for whom cardioprotective medication and, when indicated, coronary revascularization may improve perioperative outcome. On the other hand, less attention was given to the role of anaesthesia and monitoring techniques in the cardiac risk management of high-risk patients undergoing non-cardiac surgery. The aim of this review was to summarize the current evidence from published studies on the effect of the type of anaesthesia and monitoring techniques on perioperative cardiac outcome in non-cardiac surgery.

* Semmelweis University, Department of Cardiovascular Surgery, Budapest, Hungary

University of Pecs School of Medicine, Department of Anaesthesia and Intensive Care, Pecs, Hungary

Correspondence to: M. D. Kertai, Department of Cardiovascular Surgery, Semmelweis University, Varosmajor u 68, H-1122 Budapest, Hungary. E-mail:

Accepted for publication 17 March 2006

First published online 24 May 2006

© 2006 European Society of Anaesthesiology