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Volatile Anesthetic Agents > Cardiovascular Effect of Volatile Anesthetics > Flashcards

Cardiovascular Effect of Volatile Anesthetics Flashcards

1
Q

Cardiovascular Effects of Volatile Anesthetics: dose dependent myocardial depression

A
  • alterations in intracellular Ca homeostasis
  • inhibition of Na/Ca exchange
  • LV diastolic dysfunction?
  • LV after load effects
  • LA myocardial depression
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2
Q

Cardiovascular Effects of Volatile Anesthetics: dose dependent decrease in SBP

A
  • halothane and enflurane reduce myocardial contractility and cardiac output
  • isoflurane, desflurane and seovflurane decrease arterial blood pressure primarily as a result of reductions in LV after load
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3
Q

Cardiovascular Effects of Volatile Anesthetics:SVR

A

decrease

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4
Q

Cardiovascular Effects of Volatile Anesthetics: direct negative chronotropic effects

A
  • depress SA node

- baroreceptor reflex activity

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5
Q

Cardiovascular Effects of Volatile Anesthetics: SA node discharge

A

all agents slow rate of SA discharge via direct and indirect effects on SA node automaticity
-potential to produce bradycardia and AV conduction abnormalities

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6
Q

Cardiovascular Effects of Volatile Anesthetics: arrhythmogenicity

A
  • halothane, enflurane, and isoflurane are cardioprotective against ventricular fibrillation reduced by coronary artery occlusion and repercussion
  • halothane to a lesser extent, other volatile anesthetics sensitize myocardium to the arrhythmogenic effects of epinephrine
  • des, iso, and sevo do not sensitive the heart to ventricular extra systoles
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7
Q

Cardiovascular Effects of Volatile Anesthetics: in vitro

A

direct coronary artery vasodilation

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8
Q

Cardiovascular Effects of Volatile Anesthetics: invivo

A

coronary artery constriction
-reduction in determinants of myocardial oxygen consumption (MVo2), including HR, preload, after load, inotropic state, produced by anesthetics via metabolic auto regulation

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9
Q

Cardiovascular Effects of Volatile Anesthetics: myocardial O2 extraction and ratio of myocardial o2 delivery to MVo2 revealed

A

coronary artery vasodilation

  • halothane and isoflurane decreed myocardial O2 extraction and increased ratio of O2 delivery to consumption in isolated beating hearts
  • indicating volatile anesthetics produce direct coronary vasodilation in isolated hearts because myocardial O2 delivery exceeds MVo2 and coronary sinus O2 tension increases
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10
Q

coronary steal

A

doesn’t occur

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Volatile Anesthetic Agents (8 decks)

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