SHOULD THE ADMINISTRATION OF CARDIOVASCULAR DRUGS BE STOPPED BEFORE OPERATION

There are many patients on cardiovascular drugs on whom a surgical procedure is required. If the therapy is well adapted and tolerated, it can be administered until the morning of the day of surgery. This allows greater cardiovascular stability in the peri-operative period. However, the anaesthetist must be aware of this therapy as it may interfere with some of the anaesthetic agents. Thus the maintenance of anti-hypertensive and anti-anginal drugs may avoid hypertension and tachycardias which could induce myocardial ischaemic episodes. Only Neserpine agents, ACE inhibitors and "Bepridil" with certain components should be stopped before the operation. On the other hand, the withdrawal of beta-blockers, calcium inhibitors or Clonidine can induce a rebound effect. The withdrawal of digitalis and anti-arrhythmic drugs favours the occurrence of peri-operative arrhythmias and the withdrawal of diuretics can be responsible for new episodes of congestive cardiac failure.