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• W3131726889 abstract "Summary and Conclusion Most anesthetic techniques can conceivably have favorable effects on myocardial ischemia in certain circumstances by reducing the hemodynamic and neurohumoral stress response to pain, anxiety, and surgical trauma.12,14 There is no one ideal anesthetic drug or technique for all situations and there are many complicating factors that may influence whether or not a specific drug has the potential to protect against ischemia. These include interactions with other drugs,88 the magnitude of the stress response to surgery, the degree of myocardial damage, the presence of coronary spasm, and the degree of collateral coronary circulation. Of the inhalation anesthetics, halothane and enflurane demonstrate protective effects on the nonfailing ischemic heart in animals when excessive hypotension is avoided. In patients with coronary artery disease they are associated with a low incidence of myocardial ischemia when sensitive methods of detection are used. Isoflurane may not be the drug of choice for patients with ischemic heart disease because of its potential for causing the adverse redistribution of coronary flow. Because they either decrease or have minimal effects on myocardial oxygen consumption, fentanyl, sufentanil, diazepam, midazolam, and etomidate are the intravenous agents most likely to favorably influence myocardial ischemia. None are complete anesthetics by themselves and thus have the potential to inadequately blunt the stress response to surgery or laryngoscopy. They are probably more effectively used in combinations with each other or with an inhalation anesthetic during periods of stimulation. We currently have a great deal of knowledge about how the anesthetic agents affect hemodynamic determinants of myocardial oxygen consumption and supply. It is well recognized that the use of anesthetic drugs to limit myocardial oxygen consumption while avoiding excessive decrements in supply has the potential to reduce the incidence of and improve tolerance to myocardial ischemia. Further work needs to be done to determine how anesthetic agents affect the occurrence of coronary vasospasm, how they influence intracellular metabolism during myocardial ischemia, and whether they have any effect on coronary thrombosis." @default.
• W3131726889 created "2021-03-01" @default.
• W3131726889 creator A5026180652 @default.
• W3131726889 creator A5056103454 @default.
• W3131726889 date "1988-09-01" @default.
• W3131726889 modified "2023-09-26" @default.
• W3131726889 title "Myocardial Protection: Role of Anesthetic Drugs" @default.
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• W3131726889 doi "https://doi.org/10.1016/s0889-8537(21)00266-2" @default.
• W3131726889 hasPublicationYear "1988" @default.
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