[Cardiovascular effects of Diprivan].

Propofol is a greater cardiovascular depressant agent than barbiturates (thiopentone, methohexitone). It is agreed that propofol changes the ventricular load as a result of its vasodilating effects, and that it depresses the sympathetic nervous system and the baroreflex, which result in a moderate bradycardia. The direct effects of propofol on the myocardium remain controversial. Propofol has no significant direct effect on intrinsic myocardial contractility and the decrease in cardiac output is related to anaesthesia on the one hand and to changes in ventricular load and the activity of the cardiac autonomic nervous system on the other hand. It is therefore understandable that the overall depressant effect of the cardiovascular system is amplified in patients whose ventricular function is closely dependent upon ventricular load and/or the activity of the sympathetic nervous system, and that the association with drugs causing bradycardia must be avoided. The logical therapeutic solution to propofol related cardiovascular depression, when deemed necessary, consists of vascular fluid loading and/or the administration of a vasoconstrictor.