Interactions between cardiovascular drugs and anesthesia and surgery

Decisions about chronic treatments during the perioperative period must be made at the presurgical anesthesia consultation. It is increasingly rare to stop treatment during this period, because: - interrupting chronic treatment is associated with a rebound effect or even aggravation of the disease; - the wide range of available anesthesia techniques makes it possible to circumvent possible interactions with some anesthetic drugs. This new rule is applied particularly to patients with cardiovascular disorders. Beta blockers have a special role in preventing the onset of postoperative cardiovascular events. The role of statins requires further precision but they appear to fit into the some preventive approach. Interruption of antiplatelet agents appears to be associated with a risk of arterial thrombosis in patients with coronary conditions, notably those with conventional stents and most especially those with drug-eluting stents.