Predictive Factors of Postoperative Blood Pressure Abnormalities Following a Minor-to-Moderate Surgery

Area of Science:

• Cardiology
• Anesthesiology
• Internal Medicine

Background:

• Myocardial ischemic events pose a significant risk in non-cardiac surgery patients, especially older individuals.
• Prevalence and risk factors for postoperative blood pressure (BP) abnormalities, potential precursors to myocardial ischemia, remain underreported.
• Preoperative left ventricular diastolic function is explored as a predictive factor for these BP abnormalities.

Purpose of the Study:

• To identify predictive factors for postoperative BP abnormalities following minor-to-moderate surgery.
• To investigate the role of preoperative left ventricular diastolic function in predicting BP derangements.
• To analyze the association between echocardiographic parameters and postoperative hypertension or hypotension.

Main Methods:

• Retrospective analysis of 173 patients undergoing oral and maxillofacial surgery under general anesthesia.
• Echocardiographic assessment of left ventricular diastolic function parameters.
• Comparison of diastolic function metrics between patients with and without postoperative BP abnormalities requiring intervention.

Main Results:

• 14.4% of patients experienced postoperative BP abnormalities.
• Factors associated with BP abnormalities included older age, diabetes mellitus, lower E/A ratio, lower e', higher E/e', and larger left atrial dimension.
• Independent risk factors for hypertension were mean e', diabetes mellitus, hospitalization systolic blood pressure (SBP), and operation time.
• Hypotension was solely associated with operation time.

Conclusions:

• Left ventricular diastolic dysfunction, increased insulin resistance, elevated hospitalization SBP, and prolonged operation time are significant risk factors for postoperative BP abnormalities.
• These findings highlight the importance of assessing diastolic function and managing BP preoperatively.
• Prolonged operation time is a critical factor for both hypertension and hypotension episodes.