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Should amiodarone be discontinued before cardiac surgery?
M Van Dyck1, P Baele, M T Rennotte
1Department of Anesthesia, St. Luc University Hospital, Brussels.
Acta Anaesthesiologica Belgica
|January 1, 1988
Summary
Amiodarone use in surgery patients revealed complications, especially in cardiac surgery cases. While most issues were treatable, fatal vasoplegia occurred, highlighting risks associated with this antiarrhythmic drug.
Area of Science:
- Cardiology
- Anesthesiology
- Pharmacology
Background:
- Amiodarone is a widely used antiarrhythmic medication.
- Its long elimination half-life poses challenges for perioperative management.
- Understanding amiodarone's impact on surgical outcomes is crucial.
Observation:
- 37 patients on chronic amiodarone therapy underwent surgery.
- Non-cardiac surgery patients (8) experienced no complications.
- Cardiac surgery patients (29) faced significant complications.
Findings:
- 52% of cardiac surgery patients developed dysrhythmias.
- 24% required pacemakers due to amiodarone-related complications.
- Marked vasoplegia, including a fatal case, was observed in cardiac surgery.
Implications:
- Amiodarone withdrawal necessitates delaying surgery, increasing arrhythmia risk.
- Fatal vasoplegia is a serious, though potentially underreported, risk.
- Further studies are needed to determine the incidence of amiodarone-induced vasoplegia.