University Hospital of North Staffordshire, Stoke-on-Trent, UK.
Curr Opin Anaesthesiol. 2010 Dec;23(6):687-90. doi: 10.1097/ACO.0b013e32833eeb19.
As day surgery continues to expand, more patients will be encountered who are chronically taking a range of cardiovascular medications for the management of hypertension and ischaemic heart disease. This review will consider the available evidence relating to whether or not these medications should be continued throughout the perioperative period in ambulatory surgical patients.
There has been relatively little research in this area which is specific to ambulatory surgery and much of the available evidence from major surgery has been assembled over the many years that these medications have been in use. In order to provide a comprehensive and balanced review, we have considered relevant evidence outside of the usual review period.
Patients should continue to take beta-blockers and calcium channel blockers on the day of surgery. Continuing angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers increases the likelihood of intraoperative hypotension. This can be reduced by withholding these drugs, but will also respond to simple treatments without any apparent adverse outcomes. It may therefore simplify instructions to patients if they are told to take all cardiac medications as normal.
随着日间手术的不断发展，将有更多的慢性高血压和缺血性心脏病患者接受各种心血管药物治疗。这篇综述将考虑在门诊手术患者围手术期期间继续使用这些药物的相关证据。
该领域针对门诊手术的研究相对较少，并且大量可用于手术的现有证据来自这些药物使用多年以来的情况。为了提供全面和平衡的综述，我们考虑了通常的综述期之外的相关证据。
患者应在手术当天继续服用β受体阻滞剂和钙通道阻滞剂。继续使用血管紧张素转换酶（ACE）抑制剂和血管紧张素受体阻滞剂会增加术中低血压的可能性。通过停止使用这些药物可以降低这种可能性，但也可以通过简单的治疗来应对，而不会产生任何明显的不良后果。因此，如果告诉患者像往常一样服用所有心脏药物，可能会简化对他们的医嘱。
