[Postoperative disorders of cardiovascular function]

Cardiovascular instability is the cause of almost 50% of postoperative complications and raises postoperative mortality far above that intraoperatively. The aged patient with pre-existing heart disease represents a high postoperative risk. These patients are very susceptible to hypoxia, anemia, hypovolemia, the negative inotropic effects of certain anesthetics, and increased oxygen consumption due to shivering. The reversal of anesthetic agents is also rather debatable in these cases. Hypertension and arrhythmias are common phenomena in the recovery room. They may be aggravated by a number of factors such as metabolic and respiratory imbalances, incorrect fluid substitution, pain, or excitation. The frequency of postoperative myocardial infarction (MI) depends upon pre-existing coronary artery disease and hypertension. A medical history of heart failure or previous MI also plays an important role hemodynamic course as do the surgical procedure and the intraoperative. Postoperative hemodynamic monitoring should be performed according to the standards suggested by the American Society of Anesthesiologists. Medical treatment basically consists of symptomatic therapy and the avoidance of risk factors. Specific treatment is rarely required.