血管紧张素转换酶抑制剂和血管紧张素受体拮抗剂的围手术期应用。
Perioperative use of angiotensin-converting-enzyme inhibitors and angiotensin receptor antagonists.
作者信息
Vaquero Roncero Luis Mario, Sánchez Poveda David, Valdunciel García Joaquín José, Sánchez Barrado María Elisa, Calvo Vecino José María
机构信息
Service of Anesthesiology, Reanimation and Pain Medicine, Complejo Asistencial Universitario de Salamanca, CAUSA, Spain.
Service of Anesthesiology, Reanimation and Pain Medicine, Complejo Asistencial Universitario de Salamanca, CAUSA, Spain.
出版信息
J Clin Anesth. 2017 Aug;40:91-98. doi: 10.1016/j.jclinane.2017.04.018.
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.
研究目的
血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂围手术期治疗的临床影响。
设计
根据PRISMA声明进行系统评价。
背景
围手术期。
患者
29项研究，11项病例/病例系列研究、12项观察性研究和6项随机研究。
测量指标
动脉血压差异、难治性低血压、其他合并症。
主要结果
各项研究在测量主题方面显示出不同结果。这些结果在血压、长期发病率以及对神经轴索麻醉的影响方面存在差异。
结论
术前早晨停用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂可作为一种潜在有效的措施被推荐，证据等级较低，以减少非心脏手术围手术期低血压的发生。
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