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Preoperative inhibition of angiotensin-converting enzyme improves systemic and renal haemodynamic changes during aortic abdominal surgery

Licker, M. ; Bednarkiewicz, M. ; Neidhart, P. ; Prêtre, R. ; Montessuit, M. ; Favre, H. ; Morel, D R.

In: British journal of anaesthesia, 1996, vol. 76, no. 5, p. 632-639

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    Titre
    • Preoperative inhibition of angiotensin-converting enzyme improves systemic and renal haemodynamic changes during aortic abdominal surgery
    Auteur
    • Licker, M.. Division of Anaesthesiology, University Hospital of Geneva, Switzerland.
    • Bednarkiewicz, M.. Division of Anaesthesiology, University Hospital of Geneva, Switzerland.
    • Neidhart, P.. Division of Anaesthesiology, University Hospital of Geneva, Switzerland.
    • Prêtre, R.. Division of Anaesthesiology, University Hospital of Geneva, Switzerland.
    • Montessuit, M.. Division of Anaesthesiology, University Hospital of Geneva, Switzerland.
    • Favre, H.. Division of Anaesthesiology, University Hospital of Geneva, Switzerland.
    • Morel, D R.. Division of Anaesthesiology, University Hospital of Geneva, Switzerland.
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • British journal of anaesthesia, 1996, vol. 76, no. 5, p. 632-639
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:304486
    Summary
    We studied 22 patients undergoing aortic surgery, allocated randomly to receive, before induction of anaesthesia, a single i.v. dose of enalapril 50 micrograms kg-1 or saline. During infrarenal aortic cross-clamping, we observed similar reductions in oxygen uptake in the two groups, despite greater systemic oxygen delivery in enalapril-treated patients; angiotensin-converting enzyme inhibition prevented the reduction in cardiac output and attenuated the decrease in glomerular filtration. Changes in glomerular filtration secondary to aortic clamping were related positively to changes in renal plasma flow (r = 0.83 (saline group) and r = 0.65 (enalapril group)). Creatinine clearance on the first day after operation was significantly higher in the enalapril compared with the saline group. We conclude that enalapril pretreatment is effective in improving systemic oxygen delivery, renal plasma flow and glomerular filtration during aortic abdominal surgery