Document Detail


Beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers: should they be stopped or not before ambulatory anaesthesia?
MedLine Citation:
PMID:  20805745     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: As day surgery continues to expand, more patients will be encountered who are chronically taking a range of cardiovascular medications for the management of hypertension and ischaemic heart disease. This review will consider the available evidence relating to whether or not these medications should be continued throughout the perioperative period in ambulatory surgical patients.
RECENT FINDINGS: There has been relatively little research in this area which is specific to ambulatory surgery and much of the available evidence from major surgery has been assembled over the many years that these medications have been in use. In order to provide a comprehensive and balanced review, we have considered relevant evidence outside of the usual review period.
SUMMARY: Patients should continue to take beta-blockers and calcium channel blockers on the day of surgery. Continuing angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers increases the likelihood of intraoperative hypotension. This can be reduced by withholding these drugs, but will also respond to simple treatments without any apparent adverse outcomes. It may therefore simplify instructions to patients if they are told to take all cardiac medications as normal.
Authors:
Ian Smith; Ian Jackson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  23     ISSN:  1473-6500     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  687-90     Citation Subset:  IM    
Affiliation:
University Hospital of North Staffordshire, Stoke-on-Trent, UK. damsmith@btinternet.com
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