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체외순환 없는 관상동맥우회술을 시행 받는 환자에서 수술 전 안지오텐신 전환효소 억제제 중단이 혈역학에 미치는 영향

Other Titles
 Effect of Preoperative Omitting Angiotensin?Converting Enzyme Inhibitor on Hemodynamics in Patients Undergoing Off Pump Coronary Artery Bypass Surgery 
Authors
 이용경  ;  나성원  ;  곽영란  ;  송하나  ;  채영근  ;  남상범  ;  남순호 
Citation
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.52(1) : 34-41, 2007 
Journal Title
 KOREAN JOURNAL OF ANESTHESIOLOGY 
ISSN
 2005-6419 
Issue Date
2007
Abstract
Background Angiotensin-converting enzyme inhibitors (ACE-I) have been widely used for cardiac patients. This study investigated the effect of omitting ACE-I medication on hemodynamics during induction of anaesthesia and operation in patients chronically treated with ACE-I undergoing off pump coronary artery bypass graft surgery (OPCAB). Methods Sixty patients scheduled for OPCAB were included in this study. Patients not treated with ACE-I were included in control group (Group 1, n = 20). And then, patients treated with ACE-I more than 4 weeks were randomly divided into two groups: continuing group including patients who continued ACE-I medication until the morning of surgery (Group 2, n = 20) and discontinuing group including patients who discontinued ACE-I one day before the surgery (Group 3, n = 20). Norepinephrine (8 µg/ml) was infused when systolic blood pressure decreased below 90 mmHg during induction and operation. Amount of norepinephrine infused and hemodynamic data were recorded. Results Significantly larger amount of norepinephrine was infused in Group 2 than in other two groups during obtuse marginal artery anastomosis. Total amount of norepinephrine infused during the all coronary anatsomosis was significantly larger in Group 2 than those values in other two groups. Conclusions Continuing ACE-I treatment until the morning of surgery significantly increased the use of norepinephrine during the anastomosis. In contrast, there was no significant difference in the use of norepinephrine between Group 1 and Group 3. Discontinuing ACE-I before the surgery may helpful to maintain hemodynamics stable during coronary anastomosis in OPCAB.
Files in This Item:
T200701101.pdf Download
DOI
10.4097/kjae.2007.52.1.34
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Na, Sungwon(나성원) ORCID logo https://orcid.org/0000-0002-1170-8042
Nam, Sang Beom(남상범) ORCID logo https://orcid.org/0000-0002-9704-1866
Nam, Soon Ho(남순호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96838
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