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Canadian Anaesthetists’ Society Journal

, Volume 15, Issue 1, pp 42–55 | Cite as

Beta-Adrenergic blocking agents and anaesthesia: a review

  • Willis A. Warner
Article

Summary

Beta-adrenergic receptor blockade may have extensive use in clinical medicine. Interactions between beta-adrenergic blocking drugs and anaesthetic agents may have life-threatening ramifications and sequelae. Physiological responses to anaesthetic agents which stimulate sympatho-adrenal activity may be altered markedly.

Beta-adrenergic blocking agents are contraindicated in patients with atrio-ventricular block and idioventricular rhythm, because all cardiac electrical activity may be abolished. Relative contraindications include asthma and other broncho-spastic states and conditions predisposing towards hypoglycaemia, e.g. insulin-treated diabetes mellitus.

Anaesthetized patients subjected to beta-adrenergic blockade will have decreased tolerance to any factor that increases cardiac work. Patients with hearts dependent upon sympathetic support for survival will not tolerate removal of that support, regardless of anaesthetic agent superimposed.

Without beta-adrenergic support, evidence of falling cardiac output will be manifested as hypotension and bradycardia. Central venous pressure will rise if the myocardium fails.

Keywords

Cardiol Propranolol Cyclopropane Isoproterenol Beta Blocker 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

RéSUMé

Le blocage des récepteurs bêta adrénergiques peut être largement utilisé en clinique. Des actions réciproques entre les médicaments qui bloquent ces récepteurs et les agents anesthésiques peuvent provoquer des séquelles dangereuses pour la vie. Les réponses physiologiques aux agents anesthésiques qui stimulent l’activité sympathico-surrénalienne peuvent être sensiblement affectées.

Les agents qui bloquent les récepteurs bêta-adrénergiques sont contre-indiqués chez les sujets souffrant d’un bloc auriculo-ventriculaire d’un rythme idioventriculaire, parce que toute activité électrique du cœur peut être abolie. Parmi les contre-indications relatives, on relève l’asthme et les autres conditions broncho-spasmatiques qui prédisposent à l’hypogrycémie, par exemple les cas de diabète traités à l’insuline.

Chez les malades anesthésiés soumis à un blocage des récepteurs bêta-adrénergiques, on verra apparaître une baisse du débit cardiaque en même temps qu’une hypotension et une bradycardie. La pression veineuse centrale augmentera si le myocarde défaille.

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Copyright information

© Canadian Anesthesiologists 1968

Authors and Affiliations

  • Willis A. Warner
    • 1
  1. 1.University of Florida College of MedicineGainesvilleFlorida

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