Frequency of intraoperative hypotension after the induction of anesthesia in hypertensive patients with preoperative angiotensin converting enzyme inhibitors

Abstract

Objective: is to evaluate the intraoperative hypotension after anesthesia induction in controlled hypertensive patients who have been taking ACE inhibitors preoperatively.
 Methodology: Prospective study conducted at department of anesthesia and ICU Jinnah Postgraduate Medical Institute, Karachi, Pakistan from 1st march 2021 to 28th February 2022. Before the surgery, the patient's mean arterial pressure and blood pressure (systolic, diastolic) were recorded in the preoperative holding area. During the surgery, the primary anesthesia team maintained an intraoperative monitoring chart. After the surgery, patient was shifted to recovery room, patient was monitored for blood pressure, for at least 10 minutes after the shifting from operation theater.
 Results: There were 73.1% males and 26.9% females, 57.7% patients had hypotension. The mean age, BMI and duration of anesthesia of the patients was 54.07±6.85 years, 26.52±4.45 kg/m2 and 82.19±3.16 minutes, respectively. There were 74.7% patients had hypotension and on antihypertensive drugs other than ACE inhibitor and hypotension was occurred in 74.5% of patients who are using ACE inhibitors as antihypertensive drugs (p>0.050).
 Conclusion: Higher incidence of intraoperative hypotension in patients with controlled hypertension who are taking ACE (Angiotensin-Converting Enzyme) inhibitors. So, controlled hypertension with ACE inhibitors is a significant risk factor for intraoperative hypotension.
 Keywords: Intraoperative hypotension, ACE inhibiotrs, Hypertensive, Anesthesia, Antihypertensive