Chronic Angiotensin Converting Enzyme Inhibitors in Intermediate Risk Surgery

• Status: Completed
• Trial end date: 2016-12-01
• Target enrollment: 0
• Participant gender: All

Summary

Primary research hypothesis: Patients who continue their chronic ACEI therapy up to and including the morning of a non-cardiac, non-vascular surgery will experience more intraoperative hypotension than those who transiently hold their chronic ACEI preoperatively.

Secondary research hypothesis #1: Patients who continue their chronic ACEI up to and including the morning of a non-cardiac, non-vascular surgery will experience better postoperative control of hypertension than those who transiently hold their chronic ACEI preoperatively.

Secondary research hypothesis #2: Patients who continue their chronic ACEI up to and including the morning of a non-cardiac, non-vascular surgery will experience less acute renal failure than those who transiently hold their chronic ACEI preoperatively.

Secondary research hypothesis #3: In the subgroup of patients with a preoperative systolic blood pressure less than 110 mmHg, those who continue their chronic ACEI therapy up to and including the morning of a non-cardiac, non-vascular surgery will experience more intraoperative hypotension than those who transiently hold their chronic ACEI preoperatively.

Secondary research hypothesis #4: In the subgroup of patients above the age of 64, those who continue their chronic ACEI therapy up to and including the morning of a non-cardiac, non-vascular surgery will experience more intraoperative hypotension than those who transiently hold their chronic ACEI preoperatively.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of Nebraska
• Treatments: Angiotensin-Converting Enzyme Inhibitors; Benazepril; Captopril; Enalapril; Enalaprilat; Enzyme Inhibitors; Fosinopril; Lisinopril; Moexipril; Perindopril; Quinapril; Ramipril; Trandolapril

Criteria

Inclusion Criteria:

• Referred to the University of Nebraska Medical Center Pre-Anesthesia Screening Clinic for preoperative evaluation.

• Above referral must be in anticipation of a non-cardiac, non-vascular surgery.

• Must have been on ACE-Inhibitor therapy for at least six weeks.

Exclusion Criteria:

• Hypotension (systolic blood pressure < 90 or diastolic blood pressure <60) at the time of preoperative evaluation

• Uncontrolled Hypertension (systolic blood pressure > 150 or diastolic blood pressure > 95) at the time of preoperative evaluation

• Surgery during which vasopressor use is anticipated (carotid endarterectomy, major abdominal operations, orthopedic oncology)

• Surgery for pathology related to vasoactive substances (carcinoid, pheochromocytoma)

• Left Ventricular ejection fraction less than 40%

• Clinical evidence of decompensated heart failure at the time of preoperative evaluation

• End-stage renal disease

• Organ transplant surgeries