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Abstract

ABSTRACT: BACKGROUND: Angiotensin converting enzyme inhibitors(ACEI) play a pivotal role in the management of hypertension (11) . whether to continue or discontinue them before surgery is an everyday encountered question of both surgeon & patient, this issue is continuously submitting to debate & controversy. OBJECTIVE: To compare between the incidence of intra-operative hypotension in hypertensive patients who continue to take ACEI. & those who discontinue, & are undergoing general anesthesia for non-cardiac surgery. PATIENTS AND METHOD: A comparative study consist of 40 patients presented to the Medical City, Baghdad Teaching Hospital & Surgical specialty Hospital between July 2011,to March 2012.the age of patients range from 38-70 years old, they were 10 (25 %) men and 30 (75 %) women , they were divided into two groups; according to mode of medication, cases ( who were continued taking medication ) and control (who were discontinued medication),twenty patient each, all patients underwent different surgical interventions under general anesthesia, they were studied & monitored intra-operatively regarding development of hypotension, this was done at time interval of 5 minutes & at starting point prior to induction of general anesthesia until 20 minutes after. RESULTS: By comparing the mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) in between both groups of patients, those who were continued ACEI (group A) or those who were discontinued(group B), it had been found that no significant differences in mean SBP neither preoperatively nor at different time intra-operatively. P.value in all comparisons was > 0.05. CONCLUSION: Continuing or discontinuing ACEI before non-cardiac surgery under general anesthesia has no statistical significance regarding concern of developing intra-operative hypotension.

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