General Anaesthetic Agents and its Implication on the Cardiovascular System: A Systemic Review

Abstract

Background: This review evaluates the possible cardiac side effects of general anesthetic agents upon usage. Cardiac as well as non-cardiac surgery may precipitate adverse events including ischaemia, diverse arrhythmias and reperfusion injury. Volatile and non-volatile anesthetic agents possess cardiovascular effects that can lead to depression of cardiac contractility, arterial pressure, ventricular resistance and reflex tachycardia. However, as not all studies have demonstrated improved outcomes, the risk for undesirable haemodynamic effects must be weighed against the possible benefits of using anaesthetic agents either pre-operatively, intra-operatively or post-operatively during both cardiac and non-cardiac surgeries as well as in patients with coronary artery disease. The halogenated agents all have similar circulatory effects as seen in young, healthy volunteers during maintenance anesthesia (Cahalan MK et al., 1991; Eis S & Kramer J, 2022). The effects of anesthetics on the cardiovascular system have a complicated character, and almost all the anesthetic agents have a dose-related myocardial depression and decreases in heart rate and arterial pressure. During anesthesia, individual responses of patients against procedures such as induction, intubation, and surgical stimulation are influenced by many factors, including preoperatively used drugs, anesthesia type, preferred anesthetic agents, and the autonomic nervous system (Fee JPH et al., 1997, Pagel PS et al., 1991; Smith G et al., 2022).