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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 in Korean | WPRIM | ID: wpr-113484
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.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Arteries / Blood Pressure / Angiotensin-Converting Enzyme Inhibitors / Norepinephrine / Transplants / Coronary Artery Bypass, Off-Pump / Hemodynamics Limits: Humans Language: Korean Journal: Korean Journal of Anesthesiology Year: 2007 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Arteries / Blood Pressure / Angiotensin-Converting Enzyme Inhibitors / Norepinephrine / Transplants / Coronary Artery Bypass, Off-Pump / Hemodynamics Limits: Humans Language: Korean Journal: Korean Journal of Anesthesiology Year: 2007 Type: Article