Malinowska-Zaprzałka Małgorzata, Wojewódzka Marzena, Dryl Dorota, Grabowska Stanisława Z, Chabielska Ewa
Emergency Department, Medical University of Białystok, Waszyngtona 15A, PL 15-274 Białystok, Poland.
Pharmacol Rep. 2005 Sep-Oct;57(5):675-8.
Angiotensin converting enzyme inhibitor (ACE-I) treated hypertensive patients are well known to be at risk during general anesthesia, because of hypotension that can occur. We compared hemodynamic changes in these patients during induction of general anesthesia with propofol and etomidate - two intravenous anesthetics. Hypotension after propofol that we observed in ACE-I group versus normotension after etomidate (p < 0.001) in our opinion may be the result of additive effect of similar endothelium-dependent mechanism of action of propofol and ACE-I, i.e. increase in production and release of nitric oxide (NO). This very unique observation, however, needs further investigation to precisely define the mechanism of our finding.
众所周知，接受血管紧张素转换酶抑制剂（ACE-I）治疗的高血压患者在全身麻醉期间存在风险，因为可能会发生低血压。我们比较了这些患者在使用丙泊酚和依托咪酯这两种静脉麻醉药进行全身麻醉诱导期间的血流动力学变化。我们观察到，ACE-I组使用丙泊酚后出现低血压，而使用依托咪酯后血压正常（p < 0.001），我们认为这可能是丙泊酚和ACE-I相似的内皮依赖性作用机制产生相加效应的结果，即一氧化氮（NO）生成和释放增加。然而，这一非常独特的观察结果需要进一步研究，以准确界定我们这一发现的机制。
