Anaesthesia and XXXX .

@entity1 @entity2643 @entity1817 @entity358 @entity64533 @entity1168 @entity616
Two recent reports support and one report disputes the existence of dangerous interactions between the new @entity64533 antiarrhythmic @entity2643 and the anaesthetic state. We have reviewed our experience with 17 anaesthetics administered to 16 @entity1 taking @entity2643 . Haemodynamics and serum @entity2643 levels were evaluated where available. Twelve cases involved @entity358 ; of these, three @entity1 died. There were no deaths in the non- @entity358 group. The charts of 30 @entity1 with poor left ventricular function, who were not receiving @entity2643 but who were undergoing coronary artery bypass surgery, were reviewed to establish a comparison group. Interactions were manifested in three forms: nodal rhythm and/or complete @entity616 developed in ten of 15 @entity1 (one @entity1 had a preoperative pacemaker inserted for the @entity1817 ), poor cardiac output requiring intra-aortic balloon pump augmentation developed in six of 12 @entity358 @entity1 , or, a state of alpha adrenergic blockade leading to a low systemic vascular resistance despite alpha agonist therapy developed in two of 16 @entity1 . We conclude that dangerous, fatal interactions may occur in @entity1 taking @entity2643 who undergo general anaesthesia with @entity358 . Anaesthesia for non-cardiac surgery may be associated with haemodynamically significant @entity1168 . We recommend aggressive invasive monitoring, including pulmonary artery catheterization and consideration of an atrio-ventricular pacemaker in high risk @entity1 .
