Halothane and Ischemic Regional Myocardial Wall Dynamics

Behrenbeck, Thomas; Nugent, Michael; Quasha, Arthur L.; Hoffman, Elmer; Ritman, E L; Tinker, J. H.

doi:10.1097/00000542-198009001-00140

Cited by 9 publications

(1 citation statement)

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“…Despite the reductions of arterial pressure and myocardial contractility, it is likely that oxygen demand decreased less than oxygen supply. That the halothane-induced reduction of the coronary perfusion pressure gradient is a major determinant of the dysfunction is confirmed by the lack of effect of halothane on the ischaemic myocardium when coronary perfusion pressure and coronary blood flow are kept constant (BEHRENBECK et al 1980). If myocardial dysfunction is indeed caused by myocardial ischaemia, adrenergic beta-receptor blockade may be expected to cause significant improvement of regional function.…”

Section: Effect Of Halothane O N R E G I O N a L V E N T R I C U L A mentioning

confidence: 97%

The Interactions between β‐Blockers and Anaesthetics. Experimental Observations

Foëx

Francis

Cutfield

1982

Acta Anaesthesiol Scand

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The possibility of interactions between P-adrenoceptor antagonists and anaesthetir drugs is particulariy relevant to the anaesthetic management of patients suffering from arterial hypertension and ischaemic heart disease. Maintenance of adrenergic beta-receptor blockade in patients with ischaemic heart disease and arterial hypertension is now widely accepted in order to avoid the cardiac risks of its sudden withdrawal and also to minimize the effects of sympathetic overactivity on the cardiovascular system. However, maintenance of adrenergic beta-receptor blockade may impose some constraints on the choice of the anaesthetic agent. While no adverse interaction has been found between beta blockade and anaesthesia with halothane, halothane supplementing nitrous oxide, or isoflurane, substantial reductions of cardiac performance have been observed in the case of the association of beta blockade and anaesthesia using methoxyflurane or trichloroethylene. An adverse interaction has also been observed between propranolol and enflurane anaesthesia but not between oxprenolol and enflurane anaesthesia. Recent studies of the effects of anaesthesia in the presence of critically narrowed coronary arteries have shown that both halothane and enflurane may cause regional myocardial dysfunction. This dysfunction is minimized by oxprenolol and it appears that adrenergic beta-receptor blockade, besides improving cardiovascular stability, protects the myocardium supplied by narrowed coronary arteries.

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Section: Effect Of Halothane O N R E G I O N a L V E N T R I C U L A mentioning

confidence: 97%