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Anaesthesia and amiodarone.

B A Liberman, S J Teasdale

    Canadian Anaesthetists' Society Journal
    |November 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Amiodarone, an antiarrhythmic drug, can cause dangerous interactions during general anesthesia, especially with cardiopulmonary bypass. Patients may experience heart block, low cardiac output, or alpha-adrenergic blockade, leading to fatal outcomes.

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    Area of Science:

    • Cardiology
    • Anesthesiology
    • Pharmacology

    Background:

    • Amiodarone is a benzofuran antiarrhythmic agent.
    • Controversy exists regarding amiodarone's interactions with anesthesia.

    Observation:

    • This study reviewed 16 patients receiving amiodarone and 17 anesthetics.
    • Hemodynamics and amiodarone levels were assessed.
    • Twelve patients underwent cardiopulmonary bypass; three died.

    Findings:

    • Interactions included heart block (10/15 patients), poor cardiac output (6/12 bypass patients), and alpha-adrenergic blockade (2/16 patients).
    • No deaths occurred in the non-cardiopulmonary bypass group.
    • Comparison with 30 non-amiodarone patients undergoing bypass showed differences.

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    Implications:

    • Fatal interactions can occur with amiodarone during general anesthesia and cardiopulmonary bypass.
    • Anesthesia for non-cardiac surgery may cause significant bradyarrhythmias.
    • Recommend invasive monitoring and consideration of pacemakers for high-risk patients.