Effect of short-term yoga on myocardial protection in patients undergoing off-pump coronary artery bypass surgery: A randomized controlled study

Preoperative: Yoga sessions will be held for the patients during their hospitalization in the cardiothoracic and vascular surgery (CTVS) ward in the evening in a dedicated yoga room for a total duration of 60 min per session for five days before surgery. The yoga instructor will brief the patients about the yoga sessions and supervise the performance of the following asanas by the patients: chest exercises with breathing(10mins), anulom-vilom pranayama (10 min), udgith pranayama (10 min), nadi shodhana pranayama (5 min), sheetali pranayama (5 min), bhramari pranayama (5 min), and yog nidra/relaxation (15 min).Patients in the control group will be taken to the yoga room without a yoga intervention. Five sessions will be conducted over five days. The patient’s baseline pro-BNP and troponin I levels will be evaluated preoperatively before the start of the first session. The HADS will be used to calculate anxiety scores among the patients. It comprises seven questions for depression and seven questions for anxiety.

Inraoperatively- The SPI values range from 0 to 100, and higher values indicate a greater nociceptive (stress) response. The target range for adequate intraoperative analgesia during general anesthesia is usually 20–50. An increase in SPI > 50 will be regarded as an indicator of intraoperative pain. It will be managed with a bolus dose of 1 μg/kg of fentanyl.The vasoactive inotropic score (VIS) score will also be calculated for all the patients across both groups.

Postoperative: The proBNP, Trop I levels, and VIS score will be again measured after 6,24,48,72 hours of surgery. The anxiety score will also be calculated post-surgery after the patient has extubated and breathes spontaneously.