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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
RAMOS, Gilson et al. Peri-operative management of amiodarone patients. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.4, pp. 573-581. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942004000400013.
BACKGROUND AND OBJECTIVES: Amiodarone is quite an effective anti-arrhythmic drug indicated for controlling ventricular and supra-ventricular arrhythmias, and it is being widely administered in clinical practice. However, its chronic use may be associated to severe side effects which may be worsened by anesthetic-surgical acts, thus increasing the risk of such procedures. This study aimed at reviewing major amiodarone effects and relating them to anesthetic procedures. CONTENTS: The study covers major amiodarone properties, its clinical use, as well as major adverse effects, which may increase patient's surgical risk. CONCLUSIONS: Amiodarone, although normally safe and effective, may present adverse effects, especially on cardiovascular system, during anesthetic-surgical procedures. This is possibly due to interactions between this drug and anesthetic agents mainly related to general anesthesia. There are reports on severe, treatment - resistant bradycardias as well as on different degrees of atrioventricular block (AVB). Patients should be carefully monitored, especially during major procedures, and vasoactive drugs (isoproterenol) and temporary artificial pacemaker, should be available because they may be critical during the adverse effects treatment.
Keywords : COMPLICATIONS [arrhythmias]; COMPLICATIONS [hypotension]; COMPLICATIONS [liver toxicity]; COMPLICATIONS [respiratory]; COMPLICATIONS [thyroidal]; DRUGS [amiodarone].