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...