Anaesthesia exerts direct and indirect effects on the peripheral circulation. As in the case of the heart, it is difficult to differentiate between direct and indirect effects under in vivo conditions. Decreased sympathetic drive, which is associated with virtually any anaesthetic technique, will also affect peripheral vascular tone. This can be expected to alter regional vascular resistances, blood flows, and the distribution of intravascular blood volume. In addition, many anaesthetic agents exert direct effects on vascular smooth muscle, either by direct vasodilation or by altering the response to other factors that modulate vascular tone.
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