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논문 기본 정보

자료유형
학술저널
저자정보
Dong Soo Han (Department of Anesthesiology and Pain Medicine Chonnam National University Medical School Gwangju K) Jia Song (Department of Anesthesiology and Pain Medicine Chonnam National University Medical School Gwangju K) Myung Ha Yoon (Department of Anesthesiology and Pain Medicine Chonnam National University Medical School Gwangju K) Seongheon Lee (Department of Anesthesiology and Pain Medicine Chonnam National University Medical School Gwangju K)
저널정보
조선대학교 의학연구원 Medical Biological Science and Engineering Medical Biological Science and Engineering Vol.2 No.1
발행연도
2019.1
수록면
6 - 11 (6page)

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Continuing angiotensin receptor blockers (ARBs) until the day of surgery remains controversial because of the risk of intraoperative hypotension. This study was aimed at evaluating the perioperative hemodynamic changes and postoperative complications associated with continuation or discontinuation of ARBs in patients undergoing laparoscopic cholecystectomy. A total of 283 patients with antihypertensive medication, including ARBs, were enrolled in this retrospective study. On the day of surgery, ARBs were continued in some patients (continuation group, n=111) and discontinued in other patients (discontinuation group, n=172). On the basis of the patients’ electronic medical records, hemodynamic values (systolic blood pressure, mean arterial pressure, and heart rate) were compared before anesthesia (baseline), at 10 min after induction (post-induction), and on arrival at the post-anesthesia care unit (postanesthesia). Vasoactive drug use, postoperative complications, and length of hospital stay were compared. The blood pressures and heart rates at baseline and post-induction were not significantly different between the groups. The number of patients who required ephedrine to correct intraoperative hypotension was significantly higher in the continuation group than in the discontinuation group (27.9% vs. 14.5%, p=0.009). The systolic blood pressure at postanesthesia was significantly higher in the discontinuation group (159.9±21.7 vs. 146.4±20.9, p<0.001). The postoperative complications and length of hospital stay were similar. Discontinuing ARBs may reduce the incidence of intraoperative hypotension requiring pharmacological intervention in patients undergoing laparoscopic cholecystectomy; however, possible occurrence of postoperative hypertension should be considered.
#Angiotensin receptor blockers #Antihypertensive agents #Laparoscopic cholecys– tectomy #Preoperative period #Renin-angiotensin system

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참고문헌 (17)

참고문헌 신청
Rabasseda X / 2004 / Treatment of hypertension in 2004: new research disclosed during the Annual Meeting of the American Society of Hypertension / Timely Top Med Cardiovasc Dis 8:E5 google schola Yusuf S / 2000 / Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients / N Engl J Med 342:145~153 google schola Anderson JL / 2007 / ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine / J Am Coll Cardiol 50:e1~e157 google schola Mancia G / 2013 / 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) / J Hypertens 31:1281~1357 google schola Roshanov PS / 2017 / Withholding versus continuing angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers before noncardiac surgery: an analysis of the vascular events in noncardiac surgery patlents cohort evaluation prospective cohort / Anesthesiology 126:16~27 google schola

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