Effect of Preoperative Omitting Angiotensin-converting Enzyme Inhibitor on Hemodynamics in Patients Undergoing Off Pump Coronary Artery Bypass Surgery / 대한마취과학회지
Korean Journal of Anesthesiology
; : 34-41, 2007.
Article
em Ko
| WPRIM
| ID: wpr-113484
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
Angiotensin-converting enzyme inhibitors (ACE-I) have been widely used for cardiac patients. This study investigated the effect of omitting ACE-I medication on hemodynamics during induction of anaesthesia and operation in patients chronically treated with ACE-I undergoing off pump coronary artery bypass graft surgery (OPCAB).METHODS:
Sixty patients scheduled for OPCAB were included in this study. Patients not treated with ACE-I were included in control group (Group 1, n = 20). And then, patients treated with ACE-I more than 4 weeks were randomly divided into two groups continuing group including patients who continued ACE-I medication until the morning of surgery (Group 2, n = 20) and discontinuing group including patients who discontinued ACE-I one day before the surgery (Group 3, n = 20). Norepinephrine (8microgram/ml) was infused when systolic blood pressure decreased below 90 mmHg during induction and operation. Amount of norepinephrine infused and hemodynamic data were recorded.RESULTS:
Significantly larger amount of norepinephrine was infused in Group 2 than in other two groups during obtuse marginal artery anastomosis. Total amount of norepinephrine infused during the all coronary anatsomosis was significantly larger in Group 2 than those values in other two groups.CONCLUSIONS:
Continuing ACE-I treatment until the morning of surgery significantly increased the use of norepinephrine during the anastomosis. In contrast, there was no significant difference in the use of norepinephrine between Group 1 and Group 3. Discontinuing ACE-I before the surgery may helpful to maintain hemodynamics stable during coronary anastomosis in OPCAB.Palavras-chave
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Base de dados:
WPRIM
Assunto principal:
Artérias
/
Pressão Sanguínea
/
Inibidores da Enzima Conversora de Angiotensina
/
Norepinefrina
/
Transplantes
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Ponte de Artéria Coronária sem Circulação Extracorpórea
/
Hemodinâmica
Limite:
Humans
Idioma:
Ko
Revista:
Korean Journal of Anesthesiology
Ano de publicação:
2007
Tipo de documento:
Article