Should amiodarone be discontinued before cardiac surgery?

  • 1 January 1988
    • journal article
    • case report
    • Vol. 39  (1) , 3-10
Abstract
Between October 1985 and October 1986, 37 patients, chronically treated with amiodarone, underwent general anesthesia for cardiac, thoracic or vascular surgery. Among them, the 8 non-cardiac surgery patients showed neither intra-, nor postoperative complications. The 29 cardiac surgery patients, had various complications ranging from dysrhythmias (52%), sometimes necessitating a pacemaker (24%), to marked and even fatal vasoplegia. We describe the only fatal case and compare our complication rate with that described in the available literature. Most complications could be symptomatically treated. In addition, amiodarone has a very long elimination half-life: therefore withdrawal before surgery implies delaying operations by several weeks, and puts patients at increased risk of malignant dysrhythmias. However, fatal vasoplegia does occur, and its real incidence should be assessed by a broader survey.

This publication has 0 references indexed in Scilit: