![]() Therefore, prevention of the redistribution of blood during anesthesia might be a good option to avoid hemodynamic instability and the adverse effects of intravenous fluids and cardiovascular active agents. Additionally, the administration of ephedrine has a risk of myocardial ischemia due to severe tachycardia. However, many previous reports have shown the risks of fluid overload although the role of perioperative fluid management remains under debate. In clinical practice, large volumes of fluid or short-acting cardiovascular active agent such as ephedrine may be administered to counteract anesthesia-induced hypotension. ![]() Consequently, blood pressure drops result from decreased cardiac output and SVR during general anesthesia induction. Also, positive pressure ventilation decreases cardiac output result from effects on the right heart. The redistribution may decrease cardiac preload and results in a decrease in the stroke volume (SV) according to the Frank-Starling’s law. Because anesthetics redistribute the blood from the central to the peripheral compartment secondary to vasodilatation for the reasons above, hemodynamic instability is common during the induction of general anesthesia and preparation for operation. ![]() Furthermore, anesthesia decrease sympathetic activity before surgical stimulation. The effect of anesthetics decrease systemic vascular resistance (SVR) and venous return. Modern anesthetics have vasodilatory effect with minimal myocardial depression.
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