الفهرس | Only 14 pages are availabe for public view |
Abstract Our study is aimed to assess and evaluvate perioperative haemodynamic changes in hypertensive patients chronically treated by angiotensin converting enzyme inhibitor undergoing elective surgery under general anaesthesia. We aimed To study the haemodynamic changes on patients continuing/discontinuing Angiotensin Converting Enzyme inhibitor on the day of surgery. Our study was prospective randomized double blinded study ,it studied 100 patients going for elective surgery were selected in the surgery ward of Minia university hospital . Amongst them, 50 patients (control group –group B) did not consume any ACEI for controlling BP on the day of surgery but the remaining 50 patients (experimental group- group A) used the drugs on the day of surgery . In these groups the effect of angiotensin converting enzyme inhibitors on hemodynamic changes before, during and after surgery were studied by heart rate,blood pressure, ,SpO2 . We founded that there were no statistically difference among the 2 groups with regard to: age ,sex ,type of ACEI and type of operation. Pre-induction HR, SBP, DBP and MAP were comparable between groups( pre op “P” value > 0.05). However when the post-induction values were compared with subsequent readings at 1min(“P” value< 0.05), 3 min (“P”value0<.05)and 5 min(“P”value0<.05) ,15 min (“P”value0<.05) it was found that there was a significant reduction in HR, SBP, DBP and MAP in group A up to 20 min,There was no SpO2 changes in both groups. We founded that the continuation of ACEI into the perioperative setting produces hypotension after induction of GA but it was for short time and easily controlled by intravenous crystalloid , it can be concluded that intraoperative hemodynamics can be more safely managed when these agents were taken on the day of surgery. |