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Suggest General Anethesia That Do Not Cause Heart Palpitations

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Posted on Mon, 6 Apr 2015
Question: Are there any general anesthesias which could be considered non-stimulatory, and which do not result in heart palpitations or arrythmias?
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Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
Etomidate seems to have a safe cardiovascular risk profile.

Detailed Answer:
Hello! Thank you for asking on HCM! Regarding your concern I would explain you that the appropriate anesthesia profile depends on the surgical procedure profile. Nevertheless one of the most safe anesthesia regarding its safe cardiovascular risk profile is anesthesia by using etomidate. But remains on the surgical and anesthesiologist team decision to choose the most appropriate anethsesia regimen and the specific drug. They are the right persons to make the best choices (as they know the specific patient and his pathology; and also can serve their best experience on applied and approved protocols).
Hope to have been helpful to you! Greetings! Dr. Iliri.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Ilir Sharka (11 hours later)
Thank you much Dr. Sharka, and greetings to you from America! Cardiologically I have PVCs, and electrocardiogram notes stating "RSR' our QR pattern in V1 suggests right ventricular conduction delay" - and I was told RSR' pattern in V1 could be indicative of incomplete right bundle branch block (RBBB). I also tend to have higher homocysteine levels, usually around 12 umol/L, but once as high as 18 umol/L. The procedures necessitating anesthesia would be (a) a gastric endoscopy, for which they probably would use fentanyl and versed, and (b) a surgical repair of an umbilical incisional hernia, for which they would want to use XXXXXXX (I think it stands for total intravenous anesthesia), some other propofol anesthesia, and/or desflorine gas. Would you believe that these anesthesias would be regarded as non-stimulatory and low-risk when it comes to heart palpitations and arrythmias? I could certainly ask about etomidate. :)
doctor
Answered by Dr. Ilir Sharka (16 hours later)
Brief Answer:
Use of anesthesia drugs is short-acting and under comprehensive monitoring.

Detailed Answer:
Hello again! Regarding your concern about arrhythmia risk of anesthesia drugs you mentioned above, I would explain that there exist few papers referring a slight increase of arrhythmia for fentanyl or desflorine, as well as others speaking about anti-arrhythmic as well as pro-arrhythmic effects of propofol, but in general these drugs are proven to be safe and appropriate for the large community of patients that undergo different kinds of surgery. Sure that all drugs may exert potential side effects, including cardiac ones; but the most important thing is continuous comprehensive monitoring during the process and abruptly appropriate interventions to neutralize any possible complications (all the above are available in a surgical contemporary environment; so relax and don't worry too much).
The main issue I would underline regarding your concern is your cardiac-pulmonary functional status. The real actors contributing to anesthesia complications are not the drugs used during the process, but the existing cardiac and pulmonary (as well as other vital organs) pathologies severely compromising organ functioning (presence of organ failures).
I recommend you to perform a cardiac ultrasound before the above mentioned procedures; to rule out any substrates for generating arrhythmia (low EF, presence of any cardiomyopathy, severe valvular dysfunctions, etc).
In your case, I would add that RBBB or even non complex ventricular arrhythmia (isolated PVCs) are not contraindications for any kinds of surgery.
At the end I recommend you again to trust your attending doctors as they are going to use the best appropriate drugs that result from their daily clinical experiences and the approved medical protocols of the respective medical centers.
My Best Wishes!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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Suggest General Anethesia That Do Not Cause Heart Palpitations

Brief Answer: Etomidate seems to have a safe cardiovascular risk profile. Detailed Answer: Hello! Thank you for asking on HCM! Regarding your concern I would explain you that the appropriate anesthesia profile depends on the surgical procedure profile. Nevertheless one of the most safe anesthesia regarding its safe cardiovascular risk profile is anesthesia by using etomidate. But remains on the surgical and anesthesiologist team decision to choose the most appropriate anethsesia regimen and the specific drug. They are the right persons to make the best choices (as they know the specific patient and his pathology; and also can serve their best experience on applied and approved protocols). Hope to have been helpful to you! Greetings! Dr. Iliri.