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Clinical Research Article
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DOI: https://doi.org/10.4097/kja.23658
- Comparison of effects of telmisartan versus valsartan on post-induction hypotension during noncardiac surgery: a prospective observational study
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Chung-Sik Oh1,2
, Jun Young Park1
, Seong-Hyop Kim1,2,3
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1Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
2Institute of Biomedical Science and Technology, Konkuk University School of Medicine, Seoul, Korea
3Department of Medical Education, Konkuk University School of Medicine, Seoul, Korea
- Corresponding author: Seong-Hyop Kim ,Tel: +82-2-2030-5454, Fax: +82-2-2030-5449, Email: yshkim75@kuh.ac.kr
- Received: September 1, 2023; Revised: December 24, 2023 Accepted: December 26, 2023.
- Abstract
- Background
Telmisartan is considered more potent than valsartan. Hemodynamic response during anesthesia induction may be influenced by anti-hypertension (HTN) medication. The present study compared the effect of anti-HTN medications on post-induction hypotension during noncardiac surgeries.
Methods
This observational study standardized the anesthetic regimen across patients, with hypotension defined as mean blood pressure (BP) of less than 65 mmHg. The hemodynamic changes within 5 min before and after endotracheal intubation, and within 10 min before and after surgical incision were measured. Transthoracic echocardiographic evaluation of the left ventricle (LV) during anesthesia induction was performed. The primary endpoint was the decline in mean BP after anesthetic administration in telmisartan and valsartan groups. Multivariate logistic regression analysis was used to identify predictors of post-induction hypotension.
Results
Data from 157 patients undergoing noncardiac surgery were analyzed. No significant differences were found in mean BP decline between the two groups during anesthesia induction. Hemodynamic changes and LV ejection fraction (EF) during anesthesia induction were similar between the groups. Age and preoperative initial mean BP in operation room (OR) were associated with post-induction hypotension in both groups.
Conclusions
The angiotensin receptor blocker (ARB) type did not influence post-induction hypotension during anesthesia induction. Age and preoperative initial mean BP in OR were associated with post-induction hypotension in patients taking ARBs.
Keywords :Anesthesia; Angiotensin receptor antagonists; General surgery; Hypotension; Telmisartan; Valsartan.
