Pharmacology of Anesthetic Drugs

Lester, Laeben; Mitter, Nanhi; Berkowitz, Dan E.; Nyhan, Daniel

doi:10.1016/b978-0-323-49798-5.00007-3

Cited by 5 publications

(2 citation statements)

References 491 publications

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“…Particularly in patients with cardiovascular complications, anesthesiologists should administer anesthetic agents carefully to avoid cardiovascular depression. For such populations, the methods and agents for general anesthesia may be applied variously depending on the anesthesiologists' experience and institutional policy [ 12 ]. While the dose of sedative agents is decreased to minimize the effects of agent on hemodynamics, anesthesiologists require scrupulous attention to intraoperative awareness [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Remimazolam Anesthesia for MitraClip Implantation in a Patient with Advanced Heart Failure

Satoh

Nishihara

Sawashita

et al. 2021

Case Reports in Anesthesiology

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Remimazolam, a novel and ultrashort-acting benzodiazepine, has been available for general anesthesia in Japan. The administration of remimazolam does not induce injection pain, has been reported to have less cardiovascular depressant effects during general anesthesia, and flumazenil can antagonize the effects of remimazolam. However, in clinical trials, no patient who is complicated with severe heart failure or undergoes cardiac surgery was included. We present anesthetic management with remimazolam for MitraClip® implantation in a patient with severe mitral regurgitation and advanced heart failure. Remimazolam was administered both in anesthetic induction and maintenance with less cardiovascular depressant effects. After surgical procedures were completed, the patient smoothly recovered from anesthesia and the tracheal was extubated just after administration of flumazenil. Remimazolam may be able to achieve appropriate anesthetic management in patients complicated with severe cardiovascular diseases.

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Section: Discussionmentioning

confidence: 99%

Remimazolam Anesthesia for MitraClip Implantation in a Patient with Advanced Heart Failure

Satoh

Nishihara

Sawashita

et al. 2021

Case Reports in Anesthesiology

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“…Etomidate 3,7,10 is a carboxylated imidazole derivative, has a rapid onset (10-60 sec), a brief duration of action (3-5 min), and hydrolyses primarily in liver. It provides hemodynamic stability in both noncardiac and cardiac disease patients after dosage of 0.15 to 0.30 mg/kg.…”

Section: Introductionmentioning

confidence: 99%

Comparison of hemodynamic effects of etomidate and propofol as an induction agent in patients with LVEF 40% undergoing elective coronary artery bypass grafting surgery – A prospective and randomized study

Carpenter¹,

Soni²,

Goyal³

et al. 2021

IJCA

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This study aims to compare the hemodynamic response of two commonly used induction agents Propofol and Etomidate in patients with left ventricular ejection fraction ≤40% undergoing Coronary Artery Bypass Grafting surgery. To compare the effects of Propofol and Etomidate on hemodynamics in terms of heart rate, rhythm, blood pressure, and central venous pressure. Narayana Multispeciality Hospital, Jaipur. Prospective, double-blinded, randomized, hospital based study.100 patients with LVEF≤40% scheduled for elective CABG, were randomly assigned to one of the two groups receiving either of the inducing agents, group A (PROPOFOL 2mg/kg) and group B (ETOMIDATE 0.2mg/kg). Unpaired t-test and Chi square test/Fisher exact test, p<0.05 was taken as significant. HR, SBP, DBP and MAP decreased from post induction 1 min. to post induction 3 min. (fall greater in propofol, p>0.005) then increased from post intubation 1 min. to post intubation 5 min. in both the groups (rise greater in etomidate group, p<0.005). Need of drugs to control hypotension (62% and 26%, p=0.001) and to control pressor response (10% and 38%, p=0.002) was observed in both the groups. Etomidate is superior to propofol in providing hemodynamic stability before and after laryngoscopy and intubation, but less effective in controlling the pressor response to intubation. Therefore, Etomidate can be used as an induction agent with suitable adjuvants to control pressor response to tracheal intubation in patients undergoing CABG with low LVEF.

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