Baillard C
Service d'anesthésie-réanimation, UPRES 39-04, hôpital Avicenne, 125, avenue de Stalingrad, 93009 Bobigny, France.
Ann Fr Anesth Reanim. 2005 Nov-Dec;24(11-12):1360-74. doi: 10.1016/j.annfar.2005.06.013. Epub 2005 Aug 11.
This review focuses on potential drug interactions between anaesthetic drugs or techniques and chronic medications in patients scheduled for surgery. The vast majority of therapeutics can be continued until the morning of surgery. However, for some drugs such as ACE inhibitors, there is strong evidence to recommend their discontinuation prior to surgery. When juged necessary, interruption of chronic therapeutic needs to be anticipated and planned. In the other hand, for other drugs such as beta-blockers or L-Dopa, acute withdrawal is associated with documented adverse outcome. As a result, such drugs have to be continuing throughout the operative period. Although a general consensus exists for many medications, there are still controverses as to the management of antithrombotic drugs and some central nervous system agents. Advances in anaesthesia include knowledge on the mechanisms involved in drug interactions, which allows us to improve the preoperative management of chronic therapeutics.
本综述聚焦于拟行手术患者中麻醉药物或技术与慢性药物之间潜在的药物相互作用。绝大多数治疗药物可持续使用至手术当日早晨。然而，对于某些药物，如血管紧张素转换酶抑制剂，有充分证据建议在手术前停用。在判断有必要时，需要预期并规划中断慢性治疗。另一方面，对于其他药物，如β受体阻滞剂或左旋多巴，急性撤药会伴有已记录的不良后果。因此，此类药物在整个手术期间必须持续使用。尽管对于许多药物已达成普遍共识，但在抗血栓药物和一些中枢神经系统药物的管理方面仍存在争议。麻醉学的进展包括对药物相互作用机制的认识，这使我们能够改进慢性治疗药物的术前管理。
