Abstract

PALADINO, Miguel Angel  and  SCHEFFELAAR KLOTZ, Sabrina Alejandra. EL PACIENTE HIPERTENSO Y LA ANESTESIA. Anest Analg Reanim [online]. 2003, vol.18, n.1. ISSN 1688-1273.

Circulatory stability is one of the main objectives of the perioperative management of high risk patients. Most of these patients are chronically treated because of cardiovascular diseases, which interfere with the functioning of several physiological systems aimed at maintaining the circulatory status when the loading conditions of the heart deteriorates , or limit the compensatory mechanisms used when metabolic needs increase. Taking in consideration the pharmacology of these medications, their effects on perioperative haemodynamics and their potential beneficial actions on regional circulations, it has become possible to determine whether or not they must be given or withdraw perioperatively. This review describe the interactions between cardiovascular physiology , treatments and anaesthesia, for the most often medications chronically taken by high risk patients, or prophilactically administered in the perioperative period. The beta blockers and calcium antagonists must be continued until the day of the surgery. The angiontensin converted enzime inhibitor (ACEI), and angiotensin II receptor antagonists, have potential adverse effects on intraoperative blood pressure stability, therefore should be suspended 12 to 36 previous hours to the surgery ( with the exception in hypertensive cardiopathy and cardiac insufficiency). It should take in consideration other interactions between agents that markedly limit the body’s compensatory mechanisms, trying to meet demands of the increase of metabolic requirements, and thus maintain the hemodinamic stability.

Keywords : anesthesia; antihypertensive drugs; drugs interaction.

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