Mechanisms of anesthesia-induced depression of myocardial function

Anesthetics may depress myocardial function. Part of this action is due to a direct negative inotropic effect of these agents. With the increasing knowledge on the cardiac excitation-contraction process, the understanding of the different possible mechanisms, underlying the anesthetic-induced myocardial depression also increases. The present state of knowledge on these possible mechanisms is reviewed and they are discussed as to their relative importance and their clinical relevance