Correlation between postprandial hypotension and post-induction hypotension in the elderly: a protocol for a...

Area of Science:

• Anesthesiology
• Geriatric Medicine
• Cardiovascular Physiology

Background:

• Post-induction hypotension (PIH) is a common complication in elderly patients undergoing general anesthesia, linked to autonomic nervous system (ANS) dysfunction and poor postoperative outcomes.
• Postprandial hypotension (PPH), also associated with ANS dysfunction, is prevalent in the elderly population.
• Current perioperative tools for assessing ANS function are limited, highlighting a need for predictive markers.

Purpose of the Study:

• To explore the relationship between postprandial hypotension (PPH) and post-induction hypotension (PIH) in elderly patients undergoing non-cardiac surgery.
• To investigate the potential of PPH as a predictor for PIH in this vulnerable patient group.
• To enhance understanding of hemodynamic instability factors in elderly patients during general anesthesia.

Main Methods:

• A prospective observational cohort study involving 120 elderly Chinese patients (≥65 years) undergoing non-cardiac surgery.
• PPH assessed via blood pressure monitoring for 120 minutes post-meal; PIH monitored from OR entry to 20 minutes post-anesthesia induction.
• PIH defined as SBP <90 mmHg, MAP <65 mmHg, or >30% drop from baseline within 20 minutes of anesthesia induction.

Main Results:

• This section is to be filled once the study is completed and results are available.
• Further analysis will correlate PPH measurements with the incidence and severity of PIH.
• Secondary outcomes include intraoperative hypotension, postoperative complications, 30-day mortality, and functional status (12-item WHODAS 2.0).

Conclusions:

• This study aims to establish whether PPH can serve as a predictive marker for PIH in elderly surgical patients.
• Findings may inform the development of novel strategies for identifying patients at risk of hemodynamic instability during anesthesia.
• Improved prediction of PIH could lead to targeted interventions, reducing postoperative complications and improving outcomes in geriatric anesthesia.