Angiotensin Converting Enzyme Inhibitors, to Continue or Discontinue on the Morning Day of Surgery

Abstract

ABSTRACT: BACKGROUND:Angiotensin converting enzyme inhibitors(ACEI) play a pivotal role in the management ofhypertension(11). whether to continue or discontinue them before surgery is an everyday encounteredquestion of both surgeon & patient, this issue is continuously submitting to debate & controversy.OBJECTIVE: To compare between the incidence of intra-operative hypotension in hypertensive patients whocontinue to take ACEI. & those who discontinue, & are undergoing general anesthesia for non-cardiacsurgery.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 38-70years 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 (whowere discontinued medication),twenty patient each, all patients underwent different surgicalinterventions under general anesthesia, they were studied & monitored intra-operatively regardingdevelopment of hypotension, this was done at time interval of 5 minutes & at starting point prior toinduction of general anesthesia until 20 minutes after.RESULTS: By comparing the mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) in betweenboth groups of patients, those who were continued ACEI (group A) or those who werediscontinued(group B), it had been found that no significant differences in mean SBP neither preoperativelynoratdifferenttimeintra-operatively.P.valueinallcomparisonswas>0.05.CONCLUSION:Continuingor discontinuing ACEI before non-cardiac surgery under general anesthesia has nostatistical significance regarding concern of developing intra-operative hypotension.