EFFECT OF ANAESTHETIC AGENTS ON CARDIOVASCULAR SYSTEM. www.anaesthesia.co.in firstname.lastname@example.org. CARDIOVASCULAR SYSTEM. Cardiac output (Stroke volume x Heart rate) Systemic vascular resistance (B.P. / C.O.) Coronary blood flow & autoregulation Arrhythmogenicity.
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Sensitizes heart to Epi
automaticity of SAN
Slows myocardial conduction
Coronary steal phenomenon
Coronary stenosis + coronary perfusion pressure Detrimental redistribution of coronary blood flow with Isoflurane Contractile dysfunction; more in region distal to a critical coronary stenosis Avoided if CPP restored
Lignocaine > Etidocaine > Bupivacaine
Recovery of Na+ channels from lignocaine is complete, even at high HRs
Depresses rapid phase of depolarization more
Rate of recovery from use-dependent block slower
Incomplete restoration of Na+ channels available between action potentials, esp at high HRs
Anti - arrhythmic
Bupivacaine : R- bupi more cardiotoxic.
Prolonged PR-interval & QRS complex, predisposition to re-entrant arrhythmias, VT / VF / Heart blocks / CHF (due to loss of contractility) resistant to defibrillation
* To surgery