Perioperative Hypertension Management during Facelift under Local Anesthesia with Intravenous Hypnotics

Area of Science:

• Anesthesiology
• Cardiology
• Plastic Surgery

Background:

• Perioperative hypertension is common, affecting both normotensive and hypertensive patients.
• Elevated blood pressure, particularly systolic, is a critical risk factor for hematoma post-facelift surgery.
• Maintaining blood pressure within target ranges (<150/65 mm Hg) is crucial for patient safety.

Purpose of the Study:

• To review causes of perioperative hypertension.
• To analyze treatment strategies for perioperative hypertension across preoperative, intraoperative, and postoperative periods.
• To provide knowledge for safe local anesthesia with IV hypnotics during facelift surgery.

Main Methods:

• Review of literature on causes of perioperative hypertension (anxiety, epinephrine, pain, PONV).
• Analysis of antihypertensive drugs (atenolol, clonidine, nifedipine) for preoperative use.
• Evaluation of intraoperative IV hypnotics (propofol, midazolam, ketamine, dexmedetomidine).
• Assessment of postoperative antiemetics (metoclopramide, ondansetron).

Main Results:

• Identified key causes of perioperative hypertension.
• Detailed characteristics and interactions of various anesthetic and antihypertensive medications.
• Provided a framework for managing blood pressure during different surgical phases.

Conclusions:

• Effective management of perioperative hypertension is vital for preventing surgical complications.
• Specific pharmacologic interventions are available for each surgical stage.
• Safe application of local anesthesia with IV hypnotics is feasible for facelift procedures.