Perioperative management of cardiovascular medication

Abstract

Many surgical patients are taking regular cardiac medications and as a result, the perioperative management of cardiac medications poses challenges for anesthesiologists. Decisions must be made based on a risk-benefit analysis for each patient. In general, medications associated with known morbidity, if withdrawn abruptly, should be continued in the perioperative period. In contrast, medications that are thought to increase the risk of perioperative complications should be held. However, the lack of evidence is reflected by the large variation in perioperative management recommendations among anesthesiologists. This article focuses on cardiac medications known to have perioperative effects and also offers a guide to the perioperative management of cardiac management.