Perioperative use of angiotensin-converting-enzyme inhibitors and angiotensin receptor antagonists.

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.