lisinopril and Intracranial-Aneurysm

Continuing renin-angiotensin-aldosterone system antagonist therapy on the day of surgery is controversial, and appears to contribute to intraoperative hypotension. A patient presenting for cerebral aneurysm clipping continued her angiotensin-converting enzyme inhibitor on the morning of surgery, and subsequently experienced significant postinduction hypotension that culminated in cardiac arrest. Following successful resuscitation, she returned 6 weeks later to have her aneurysm clipped using identical anesthetic management; her blood pressure medications were held on the day of surgery.

Topics: Aged; Angiotensin-Converting Enzyme Inhibitors; Cardiopulmonary Resuscitation; Female; Heart Arrest; Humans; Hypotension; Intracranial Aneurysm; Intraoperative Complications; Lisinopril