Perioperative use of angiotensin-converting-enzyme inhibitors and angiotensin receptor antagonists

Abstract

Study objective: Clinical repercussions of perioperative treatment with ACEIs/ARBs.

Design: Systematic review according to PRISMA statement.

Setting: Perioperative period.

Patients: 29 studies 11 cases/cases series, 12 observational studies and 6 randomized studies.

Measurements: Arterial blood pressure differences, refractory hypotension, other comorbidities.

Main results: The studies show different results regarding the topics measured. They are divided in the results regarding blood pressure, long term morbidities and effects in neuraxial anesthesia.

Conclusions: Withholding AECI/ARBs on the morning prior to surgery could be recommended as a potentially effective measure, with a low level of evidence, in order to reduce the appearance of hypotension in the perioperative period of non-cardiac surgery.

Keywords: Angiotensin receptor antagonists; Angiotensin-converting enzyme inhibitors; Perioperative care/therapy.