Hemodynamic effects of anesthetic induction in patients treated with beta and 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 channel blocker 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 hemodynamic parameters 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 hypotension without 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.