The combined effects of antihypertensive drugs and anaesthetics (halothane and ketamine) on the isolated heart.

The effects of three concentrations of halothane or ketamine were investigated on isolated rabbit hearts, which were perfused with hydralazine, clonidine, propranolol or methyldopa. In hearts not subjected to the influence of an anaesthetic, clonidine was the only drug stimulating myocardial function. In those perfused with halothane or ketamine alone, both anaesthetics exerted a negative chronotropic and inotropic action in a dose-related manner. Ketamine markedly increased the coronary flow. Clonidine distinctly reduced the myocardial depression caused by halothane or ketamine. Hydralazine had no marked effects with either of these anaesthetics, except that it sensitized the hearts to the arrhythmic action of a high concentration of halothane. Propranolol, when combined with halothane, aggravated myocardial depression and decreased coronary flow. With ketamine, propranolol caused no other harmful interactions, apart from inhibiting the increase in coronary flow caused by this anaesthetic. Methyldopa intensified the myocardial depression induced by halothane, but tended to diminish that caused by ketamine. The results suggest that clonidine has a stimulatory cardiac action when combined with either of these anaesthetics. Disadvantageous interactions may exist between methyldopa or propranolol and halothane.