Preoperative medication management

Patients often have a long list of medications they take, and decisions must be made about whether to continue or hold them prior to surgery.

Cardiovascular

Beta blockers

Continue if taking chronically.

• Reduces coronary ischemia
• Prevent withdrawal

ACE/ARB

Discontinue morning of surgery. However, this is controversial.

• Inhibition of RAAS leads to refractory intraoperative hypotension

Diuretics

• discontinue 1 day prior to avoid intravascular depletion

Alpha 2 agonists

Continue if taking chronically

• Prevent rebound hypertension