Provides a summary of current recommendations for the perioperative continuation or discontinuation of common cardiovascular medications to avoid adverse interactions with anesthetics.
Guides perioperative cardiovascular medication decisions; leaves open the need for randomized trials to refine recommendations.
Demographic shifts toward an increasingly older population have resulted in a high prevalence of persons taking cardiovascular medication. Many patients on cardiovascular medications will require surgical intervention for conditions often unrelated to their cardiovascular pathology. Cardiologists and anesthesiologists alike must be knowledgeable about the potential interactions between cardiovascular drugs and anesthetics agents or adjuvant therapies administered perioperatively. Current recommendations suggest that beta blockers, calcium channel blockers, amiodarone, and alpha2 agonists should be continued throughout the perioperative period, whereas angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and diuretics should be discontinued on the morning of surgery and resumed in the immediate postoperative period, unless contraindicated.
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Wolf et al. (2010) studied this question.
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