Haemodynamic effects of anaethesia in a patient chronically treated with angiotensin converting enzyme inhibitors

A 55 year old controlled hypertensive patient, on treatment with captopril, was subjected to general anaesthesia using conventional anaesthetics. The patient had two episodes of severe hypotension and bradycardia intraoperatively which responded to intravenous crystalloids and atropine. Possible mechanism of action for such haemodynamic instability during general anaesthesia and relevant literature has been reviewed