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Hypertension following coronary surgery is generally reported at an alarmingly high incidence (35-40 per cent). A vigilant program carried out in 1977 at Montreal Heart Institute disclosed a low incidence of 3.5 per cent in 200 consecutive unselected cases. A similar programme in 1980 based on 100 patients showed an incidence of 23 per cent. This highly significant difference is felt to be related to the different anaesthetic management that has occurred since 1977. Anaesthesia for all the 200 patients was primarily morphine 1.0-1.5 mg. kg-t. The 1980 group when divided according to the main anaesthetic agent used, with 40 patients in each group, yields the following incidence of postoperative hypertension: Morphine 4 per cent Fentanyl 20 per cent Halogenated Agents 37.5 per cent We conclude that early return of sympathetic activity is likely to increase the incidence of post-operative hypertension following coronary artery surgery; hence, early awakening following this type of surgery is not in the best interest of the patient.

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