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Pharmacology of the Pulmonary Circulation

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Principles and Practice of Anesthesia for Thoracic Surgery

Abstract

The pulmonary vasculature is a complex system and studies of the effects of anesthetic drugs on this system are often contradictory. A balanced anesthetic technique with adherence to the hemodynamic goals of maintenance of right ventricular preload and right coronary perfusion is the safest choice for patients with PHTN. There are no absolute contraindications to most anesthetic drugs in patients with pulmonary hypertension. Inhaled pulmonary vasodilators can be used to optimize hemodynamic variables perioperatively, although effects on gas exchange are variable.

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Abbreviations

CO:

Cardiac output

(m)PAP:

(Mean) pulmonary artery pressure

PHTN:

Pulmonary hypertension

PVB:

Paravertebral block

PVR(I):

Pulmonary vascular resistance (index)

SVR(I):

Systemic vascular resistance (index)

TEA:

Thoracic epidural analgesia

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Authors and Affiliations

  1. Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Kingston, ON, Canada

    Cara Reimer MD, FRCPC

  2. Division of Respirology, Department of Medicine, University of Toronto and University Health Network, Mount Sinai Hospital, Women’s College Hospital, Toronto, ON, Canada

    John Granton MD, FRCPC

Authors
  1. Cara Reimer MD, FRCPC
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  2. John Granton MD, FRCPC
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Editors and Affiliations

  1. University of Toronto, Staff Anesthesiologist, Professor of Anesthesia, Toronto, M5G 2C4, Ontario, Canada

    Peter Slinger, MD, FRCPC

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Reimer, C., Granton, J. (2011). Pharmacology of the Pulmonary Circulation. In: Slinger, MD, FRCPC, P. (eds) Principles and Practice of Anesthesia for Thoracic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0184-2_9

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  • DOI: https://doi.org/10.1007/978-1-4419-0184-2_9

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