Angiotensin Converting Enzyme Inhibitors, to Continue or Discontinue on the Morning Day of Surgery
Iraqi Postgraduate Medical Journal,
2013, Volume 12, Issue 2, Pages 208-212
Angiotensin converting enzyme inhibitors(ACEI) play a pivotal role in the management of
. whether to continue or discontinue them before surgery is an everyday encountered
question of both surgeon & patient, this issue is continuously submitting to debate & controversy.
To compare between the incidence of intra-operative hypotension in hypertensive patients who
continue to take ACEI. & those who discontinue, & are undergoing general anesthesia for non-cardiac
PATIENTS AND METHOD:
A comparative study consist of 40 patients presented to the Medical City, Baghdad Teaching Hospital
& Surgical specialty Hospital between July 2011,to March 2012.the age of patients range from 38-70
years old, they were 10 (25 %) men and 30 (75 %) women , they were divided into two groups;
according to mode of medication, cases ( who were continued taking medication ) and control (who
were discontinued medication),twenty patient each, all patients underwent different surgical
interventions under general anesthesia, they were studied & monitored intra-operatively regarding
development of hypotension, this was done at time interval of 5 minutes & at starting point prior to
induction of general anesthesia until 20 minutes after.
By comparing the mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) in between
both groups of patients, those who were continued ACEI (group A) or those who were
discontinued(group B), it had been found that no significant differences in mean SBP neither preoperatively
or discontinuing ACEI before non-cardiac surgery under general anesthesia has no
statistical significance regarding concern of developing intra-operative hypotension.
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