title: Effect of angiotensin-converting enzyme inhibitors on phenylephrine responsiveness in patients with valvular heart disease.
abstract: We studied patients with valvular heart disease to investigate whether chronic preoperative treatment with angiotensin-converting enzyme (ACE) inhibitors modulates the effect of phenylephrine (PE) on anaesthesia-induced hypotension. Sixty-five patients were enrolled in the study and hypotension developed after anaesthesia in 36 (18 in the control group and 18 in the ACE inhibitor group). These patients received PE infusions, which were increased in a stepwise fashion at 10-min intervals. Increased mean arterial pressure due to PE infusion was significant only in the control group. There was no significant difference in pressor response or change in haemodynamic variables with PE infusion between the two groups. Treatment with ACE inhibitors did not increase the incidence of hypotensive episodes or significantly modify pressor response after anaesthesia in patients with valvular heart disease.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Gachon Medical School, Gil Hospital, Incheon, Korea. ylkwak@yumc.yonsei.ac.kr
authors.forename: H J
authors.initials: HJ
authors.lastname: Kwak
authors.forename: Y L
authors.initials: YL
authors.lastname: Kwak
authors.forename: Y J
authors.initials: YJ
authors.lastname: Oh
authors.forename: Y H
authors.initials: YH
authors.lastname: Shim
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.forename: Y W
authors.initials: YW
authors.lastname: Hong
mesh_terms: D000759:Adjuvants, Anesthesia / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000732:Androstanols / Q000494:pharmacology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D002316:Cardiotonic Agents / Q000494:pharmacology*; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006351:Heart Valves / Q000473:pathology*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008874:Midazolam / Q000494:pharmacology; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D010656:Phenylephrine / Q000378:metabolism*; D000077123:Rocuronium; D017409:Sufentanil / Q000494:pharmacology; D013997:Time Factors
chemical_list: D000759:Adjuvants, Anesthesia; D000732:Androstanols; D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents; D003473:Neuromuscular Nondepolarizing Agents; D010656:Phenylephrine; D017409:Sufentanil; D008874:Midazolam; D000077123:Rocuronium