**2.4 Postoperative intensive care**

Postoperative care of MMD patients undergoing revascularization surgery preferably takes place in the intensive care unit. They need to be closely monitored for any hemodynamic and neurological changes, as postoperative ischemic events have been attributed to hemodynamic swings. Invasive monitoring to continue throughout the journey to the ICU. It is crucial to avoid both hypotension and hypertension that may cause graft thrombosis and bleed respectively. Optimal control of blood pressure, oxygen supply, ventilation may help to prevent the incidence of perioperative cerebral ischemic events.

Intravenous fluid administration to maintain normovolemia and starting aspirin on the first postoperative day has been recommended. Adequate analgesia is provided to prevent agitation and increased stress, which may affect the bypass. Postoperative sedation/analgesia with dexmedetomidine and fentanyl infusion is a good choice.
