Should diuretics be held prior to surgery?

Should diuretics be held prior to surgery?

• A. Yes, hypotension may be worsened
• B. No, they should not be held
• C. Only if on beta blockers
• D. It depends on the surgeon

Answer: (A)

Holding diuretics before surgery helps prevent intraoperative hypotension by preserving intravascular volume. Diuretics reduce circulating fluid and can cause electrolyte shifts; under anesthesia, with its vasodilatory effects and potential blood loss, this can lead to a more pronounced drop in blood pressure and reduced organ perfusion. Therefore, stopping diuretics prior to the procedure is the safer approach to maintain hemodynamic stability. Continuing them would raise the risk of hypotension, and the decision isn’t appropriately based on beta-blocker use or on the surgeon alone.

Holding diuretics before surgery helps prevent intraoperative hypotension by preserving intravascular volume. Diuretics reduce circulating fluid and can cause electrolyte shifts; under anesthesia, with its vasodilatory effects and potential blood loss, this can lead to a more pronounced drop in blood pressure and reduced organ perfusion. Therefore, stopping diuretics prior to the procedure is the safer approach to maintain hemodynamic stability. Continuing them would raise the risk of hypotension, and the decision isn’t appropriately based on beta-blocker use or on the surgeon alone.