Title:Hemodynamic Changes after Continuing or Omitting Regular Angiotensin
Converting Enzyme Inhibitors before Cataract Surgery: A Comparative
Study
Volume: 19
Issue: 1
Author(s): Saeed Khademi, Reza Jouybar, Sedigheh Ahmadi*, Naeimehossadat Asmarian, Maryam Ghadimi, Mehrdad Salari and Soodabeh Emami
Affiliation:
- Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
Keywords:
Cataract, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, heart rate, blood pressure, cardiovascular disease.
Abstract:
Aims: In this study, we aimed to appraise the effects of interrupting (discontinuing) vs. continuing
Angiotensin receptor blockers (ARBs) and Angiotensin-Converting Enzyme Inhibitors (ACEIs) on
the hemodynamic changes of patients during and after cataract surgery.
Methods and Materials: Patients aged 40-70 years, American society of anesthesiologist (ASA) class II,
taking ACEI/ARB medications, who were admitted to Khalili hospital (Shiraz, South of Iran) for cataract
surgery, were enrolled in the study. Patients were randomly divided into two groups for continuing or
withdrawing the use of ACEI/ARBs. Group 1 included the patients who continued ACEI/ARB administration,
and group 2 included those who discontinued them before surgery. In the operating room, relevant
demographic information was collected in addition to the data on patients’ basic clinical status, including
heart rate and blood pressure, before induction of anesthesia, during, and after that. The collected
data were analyzed using SPSS 21, and p-values < 0.05 were considered statistically significant.
Results: Any significant differences were not revealed in demographic variables (age, sex, diabetes, hypertension,
Myocardial infarction, Smoking, and duration of drug therapy) between the two groups. Time
effect was significant (p<0.001) for systolic blood pressure, diastolic blood pressure, and heart rate, and
interaction between time*group was not significant (p = 0.431, p = 0.566, and p = 0.355) for systolic
blood pressure, diastolic blood pressure, and heart rate. However, the group effect wasn’t significant
(p=0.701, p=0.663, and p=0.669) for systolic blood pressure, diastolic blood pressure, and heart rate.
Conclusion: It seems that in some minor surgeries, such as cataract surgery, withdrawal or continuation
of ACEIs/ARBs have no significant effect on the hypotension and heart rate of patients during orafter an
operation.