Hemodynamic effects of anesthetic induction in patients treated with beta and calcium channel blockers.
BACKGROUND
The response to anesthetic induction and airway manipulation in the presence of cardiovascular disease and antihypertensive therapy has not been adequately investigated.


METHODS
The blood pressure, pulse pressure and heart rate changes at induction and following tracheal intubation were compared in patients who were on either preoperative beta-adrenergic blocker therapy (BB group, n = 20) or a combination of beta-adrenergic blocker and calcium channel blocker therapy (BB + CCB group, n = 20). A standardized anesthesia induction protocol was followed, in the two gourps.


RESULTS
No statistical difference was observed in the hemodynamic parameters between the two groups. The total number of hypotensive patients (SAP 90 <mmHg) and bradycardic episodes following induction of anesthesia were one in the BB group and eighteen in BB + CCB group and were treated with ephedrine (p = 0.000002). Two episodes of hypotension without bradycardia occurred in BB group and six in BB + CCB group and were treated with phenylephrine (p = 0.25).


CONCLUSIONS
Hypotension requiring treatment in patients receiving a combination of BB + CCB is more frequent after induction of anesthesia.
Samad
Khalid
K
Dept. of Anaesthesia, Agha Khan Univ., Karachi, Pakistan. khalid.samad@aku.edu
Khan
Fawzia
F
Azam
Iqbal
I
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects*; D001919:Bradycardia / Q000139:chemically induced; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers