HEMODYNAMIC EFFECTS OF ANESTHETIC INDUCTION IN PATIENTS TREATED WITH BETAAND 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 channelblocker 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 hemodynamicparameters 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 hypotensionwithout bradycardia occurred in BB group and six in BB + CCB group and were treated with phenylephrine (p = 0.25). Conclusion: Hypotension requiring treatment in patients receiving a combination of BB + CCB is more frequent after induction of anesthesia.