Chronic Renin-Angiotensin System (RAS) Blockade May Not Induce Hypotension During Anaesthesia for Bariatric Surgery

Obesity Surgery
Guido SalvettiFerruccio Santini

Abstract

The use of angiotensin-converting enzyme inhibitors (ACE-I) 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 ACE-I or ARB compared to a control group not treated with antihypertensive therapy. Fourteen obese subjects (mean body mass index (BMI) 47.5 kg/m(2)) treated with ACE-I or ARB and twelve obese (mean BMI 45.7 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...Continue Reading

References

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Citations

Jul 8, 2020·Anesthesia Progress·Takayuki HojoToshiaki Fujisawa
Jul 15, 2017·Current Obesity Reports·Asta LukosiuteJonathan Mark Cousins
Sep 18, 2021·Anaesthesia Critical Care & Pain Medicine·Victoria A EleyAndré A van Zundert
Jun 20, 2017·Journal of Clinical Anesthesia·Luis Mario Vaquero RonceroJosé María Calvo Vecino

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