Penghentian ACE Inhibitor dan Angiotensin II Receptor Blocker Sebelum Operasi Nonkardiak

Oleh :

Alexandra Francesca Chandra

Penghentian obat golongan angiotensin-converting enzyme inhibitor atau ACE inhibitor dan angiotensin II receptor blocker atau ARB 24 jam sebelum operasi nonkardiak belum direkomendasikan oleh pedoman klinis yang ada. Namun, efek hipotensi intraoperatif yang ditimbulkan kedua golongan obat ini membuat keamanannya pada pasien yang hendak menjalani operasi nonkardiak mulai diteliti ulang.

Obat-obat ACE inhibitor dan ARB tergolong sebagai antagonis sistem renin-angiotensin aldosteron (RAAS). Dalam 2 dekade terakhir, obat-obatan ini semakin sering digunakan karena efektivitasnya untuk menangani hipertensi, gagal jantung kongestif, penyakit jantung koroner, serta nefropati diabetikum dilaporkan baik. Banyak pasien memakai obat-obatan ini dalam jangka panjang.[1-6]

blood pressure meter and pills on the table

Di lain sisi, ada lebih dari 200 juta orang menjalani operasi nonkardiak setiap tahunnya. Dari jumlah tersebut, ada jutaan orang yang meninggal atau menderita komplikasi vaskular pada masa perioperatif, contohnya hipotensi perioperatif. Hipotensi perioperatif diketahui berhubungan dengan kejadian infark miokard, stroke, hingga kematian.[7]

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Referensi

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