Authors: Guido Salvetti Claudio Di Salvo Giovanni Ceccarini Antonio Abramo Paola Fierabracci Silvia Magno Paolo Piaggi Paolo Vitti Ferruccio Santini
Publish Date: 2015/09/02
Volume: 26, Issue: 6, Pages: 1303-1307
Abstract
The use of angiotensinconverting enzyme inhibitors ACEI and angiotensin II receptor blockers ARB for the treatment of hypertensive obese patients is steadily increasing Some studies have reported that the use of these drugs was associated with an increased risk of hypotensive episodes during general anaesthesia The number of bariatric procedures is also increasing worldwide but there is a lack of studies investigating the hypotensive effect of renin–angiotensin system RAS blockers in severely obese patients during general anaesthesia for bariatric surgery The aim of this pilot study was to evaluate hemodynamic changes induced by general anaesthesia in obese patients chronically treated with ACEI or ARB compared to a control group not treated with antihypertensive therapy Fourteen obese subjects mean body mass index BMI 475 kg/m2 treated with ACEI or ARB and twelve obese mean BMI 457 kg/m2 controls not treated with antihypertensive therapy underwent general anaesthesia to perform laparoscopic bariatric surgery Systolic blood pressure diastolic blood pressure and heart rate were monitored continuously and registered at different time points T0 before induction then at 2 5 7 10 15 20 30 60 90 120 and 150 min after induction and the last time point taken following recovery from anaesthesia A progressive reduction of both systolic and diastolic blood pressure values was observed without significant differences between the two groups A similar trend of heart rate values was observed In conclusion our pilot study suggests that RAS blockers may be continued during the perioperative period in patients undergoing bariatric surgery without increasing the risk of hypotensive episodes
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