Manejo preoperatorio de medicamentos en pacientes hipertensos

J, Claudio Nazar; F, Christian Herrera; Aballay, Alejandro

doi:10.4067/s0718-40262013000300013

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Fármacos antihipertensivos 21 -Inhibidores de enzima convertidora de angiotensina y antagonistas del receptor de la angiotensina II son los más frecuentemente utilizados. Estudios muestran aumento de la morbimortalidad postoperatoria relacionado a episodios de hipotensión moderada y severa luego de la inducción anestésica 22 , por lo que estaría recomendado la suspensión de estos fármacos al menos 24 h previas a la cirugía 23 .…”

Section: Manejo De Drogas De Uso Frecuente En El Período Preoperatoriounclassified

Paciente Adulto Mayor Y Cirugía No Cardíaca: ¿qué Debemos Saber?

H²,

Fuentes

et al. 2015

Rev Chil Cir

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elderly patient and non cardiac surgery: What should we know?The surgical procedures in elderly patients are and will be more common. They are characterized by greater morbidity and mortality than those in younger patients, so it is essential an appropriate preoperative evaluation, a diligent intraoperative monitoring and a proper management of the postoperative period. The old age has a number of physiological changes and an increased incidence of chronic diseases and together determine a decline in physiological reserve and functional capacity. In the preoperative evaluation is important a systematic assessment of comorbidities and drugs routinely prescribed, "fragility" of these patients due to the surgical procedure and the risk of developing postoperative cognitive deficit. Type of surgery, degree of urgency and patient conditions are the main factors to consider at time to choose type of anesthesia. Common complications include the development of postoperative delirium and postoperative cognitive decline, where efforts should be directed at prevention rather than treatment, because it significantly increases perioperative morbidity.Key words: Surgery, aged, 80 and over, period, perioperative, mortality, morbidity, delirium. resumenLos procedimientos quirúrgicos en pacientes adultos mayores son cada vez más frecuentes. Se caracterizan por tener mayor morbimortalidad que los realizados en pacientes más jóvenes, por lo que es esencial una apropiada evaluación preoperatoria, una acuciosa monitorización intraoperatoria y un adecuado manejo del período postoperatorio. La edad conlleva una serie de cambios fisiológicos y una mayor incidencia de enfermedades crónicas, que en conjunto determinan una disminución de las reservas fisiológicas y la capacidad funcional. En la evaluación preoperatoria son importantes una valoración exhaustiva de las comorbilidades y fármacos de uso habitual, la posible "fragilidad" de estos pacientes ante el proceso quirúrgico y su riesgo de

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Section: Manejo De Drogas De Uso Frecuente En El Período Preoperatoriounclassified

Paciente Adulto Mayor Y Cirugía No Cardíaca: ¿qué Debemos Saber?

H²,

Fuentes

et al. 2015

Rev Chil Cir

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“…La prevalencia estimada en Colombia de HTA es del 24% [2]. En el Hospital Clínico de la Pontificia Universidad Católica de Chile se encontró una prevalencia de HTA del 18,6% entre 28.810 pacientes evaluados en consulta preanestésica [3]. En nuestra institución el 24,6% de los mayores de 40 años de la consulta preanestésica (83.197) tenían historia de HTA, y en el 14,8% se le encontró una PA superior a 140/80 mmHg.…”

Section: Introductionunclassified

Consideraciones perioperatorias en pacientes con hipertensión: el día de su cirugía

Ramírez¹,

Garzón²,

Ibarra³

2023

Rev. chil. anest.

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High blood pressure readings (170/110 mmHg) are common in patients undergoing surgery during the perioperative period, which can sometimes lead to interprofessional team decision-making that can result in surgery cancellation or postponement, altering the therapeutic process of patients. Therefore, it is relevant to discuss the current approach and recommendations for these patients during the perioperative period. Methods: A non-systematic search of the literature was conducted to evaluate the evidence of the impact on perioperative outcomes after the cancellation of elective surgery in patients with blood pressure measurements on the day of surgery of 170/110 mmHg. Results: Surgical cancellation or rescheduling in patients with high blood pressure measurements on the day of surgery, with evidence of adequate prior control, did not show an increase in the morbidity and mortality of patients in the perioperative period. On the contrary, delaying the surgical procedure seeking the optimization of arterial hypertension in the immediate perioperative period without evidence of end organ damage entails therapeutic delays and increased health costs. Conclusion: Surgical cancellation with the aim of optimizing high blood pressure readings in patients with previously controlled arterial hypertension and without evidence of end organ damage has not been shown to impact perioperative outcomes. Postponing procedures with the aim of achieving control of preanesthetic blood pressure without evidence of end organ damage is not recommended. An active approach of reducing blood pressure with pharmacological interventions should be considered to facilitate intraoperative hemodynamic control of the patient.

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Manejo preoperatorio de medicamentos en pacientes hipertensos

Cited by 2 publications

References 15 publications

Paciente Adulto Mayor Y Cirugía No Cardíaca: ¿qué Debemos Saber?

Paciente Adulto Mayor Y Cirugía No Cardíaca: ¿qué Debemos Saber?

Consideraciones perioperatorias en pacientes con hipertensión: el día de su cirugía

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