Lisinopril Versus Amlodipine in Hypertensive Patients Subjected for Anesthesia

Background: Hypertension is regarded as an additional risk factor during anesthesia. Antihypertensive usage and its implications during perioperative period have unpredictable effects on hemodynamics. Objectives: To evaluate the effect of anesthesia (general) on hemodynamics in hypertensive patients chronically treated with amlodipine in comparison to patients on lisinopril. Patients and Methods: This study included sixty adults, of both sexes, aged between 40 and 60 years old, controlled hypertensive with amlodipine or lisinopril, randomly divided into four equal groups. Group AG: On amlodipine subjected for general anesthesia, Group AS: On amlodipine subjected for spinal anesthesia, Group LG: On lisinopril subjected for general anesthesia, Group LS: On lisinopril subjected for spinal anesthesia, scheduled for elective lower limb or lower abdominal surgeries. Monitoring of arterial blood pressure (SBP, DBP, MAP), HR, oxygen saturation were recorded as pre-operative basal reading , immediately after induction, every 5 minutes for 20 minutes, then every 15 minutes till the end of operation. Hypertension was considered when increase >20% from basal reading, and hypotension when decrease <20% from basal reading. Results: There were statistically significant differences as regard systolic, diastolic, mean arterial blood pressure between group AS and group LS with significant decrease in SBP, DBP, MAP more in group LS after spinal injection, also there were statistically significant differences as regard systolic, diastolic, mean arterial blood pressure between group AG and group LG with significant decrease in SBP, DBP, MAP more in group AG after induction of anesthesia. Also, there was astatistically significant difference as regard heart rate between AS and LS groups with significant decrease in HR more in group AS after spinal injection than LS group, Statistical significant difference was noticed in heart rate between AG and LG groups with significant decrease in HR more in group LS after induction of anesthesia. Conclusion: Amlodipine was better than lisinopril in its effect regarding hemodynamics in hypertensive patients subjected for anesthesia.