[Problems posed by calcium antagonists and anesthesia: pharmacology, interactions, indications].

Calcium-channel inhibitors are widely used in therapeutics. Many patients administered calcium channel inhibitors undergo surgical procedures and the cardiologists or the anaesthesiologists are concerned with pharmacological interactions with anaesthetic agents such as halogenated gases. The combination of calcium channel inhibitors and halogenated anaesthetics may exert an additive effect on myocardial depression, conduction disturbances and arterial vasodilatation. The continuation of oral calcium channel inhibitors until the day of surgery is recommended provided the use of enflurane is restrained. Calcium-channel inhibitors such as dihydropyridines are currently administered intravenously to control intra and postoperative arterial hypertension while verapamil and diltiazem are used to treat supraventricular arrhythmias and myocardial ischaemic episodes. In patients with cardiac disease, haemodynamic monitoring may allow to anticipate or to treat episodes of cardiac dysfunction associated with I.V. calcium-channel inhibitors during the perioperative period.