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[Problems posed by calcium antagonists and anesthesia: pharmacology, interactions, indications]
J J Lehot1, P G Durand, C C Arvieux
1Hôpital Cardiovasculaire et Pneumologique L. Pradel, BP Lyon-Montchat.
Annales De Cardiologie Et D'Angeiologie
|October 1, 1993
Summary
Calcium channel inhibitors combined with halogenated anesthetics may increase cardiac depression and vasodilation. Continuing oral calcium channel inhibitors is advised, but enflurane use should be limited during surgery.
Area of Science:
- Cardiology and Anesthesiology
- Pharmacology
Context:
- Calcium channel inhibitors (CCIs) are frequently prescribed medications.
- Patients on CCIs often require surgical procedures.
- Concerns exist regarding interactions between CCIs and anesthetic agents, particularly halogenated gases.
Purpose:
- To explore the potential pharmacological interactions between calcium channel inhibitors and anesthetic agents.
- To provide guidance on managing patients on CCIs during surgical procedures.
Summary:
- Combining CCIs with halogenated anesthetics can lead to additive myocardial depression, conduction disturbances, and arterial vasodilation.
- Continuation of oral CCIs until surgery is generally recommended, with caution advised regarding enflurane use.
- Intravenous CCIs like dihydropyridines manage perioperative hypertension, while verapamil and diltiazem address arrhythmias and ischemia.
- Hemodynamic monitoring is crucial for managing cardiac dysfunction in patients receiving IV CCIs during the perioperative period.
Impact:
- Informs cardiologists and anesthesiologists about potential drug interactions.
- Guides perioperative management strategies for patients on calcium channel inhibitors.
- Aims to improve patient safety and outcomes during surgery.