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Defining intra‐operative hypotension – a pilot comparison of blood pressure during sleep and general anaesthesia *
Author(s) -
Soo J. C. L.,
Lacey S.,
Kluger R.,
Silbert B. S.
Publication year - 2011
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2011.06657.x
Subject(s) - medicine , blood pressure , anesthesia , ambulatory blood pressure , general anaesthesia , continuous noninvasive arterial pressure , ambulatory , mean blood pressure , mean arterial pressure , surgery , heart rate
Summary The scientific justification for particular values of intra‐operative hypotension is poorly substantiated. To provide a rationale for appropriate values we recorded blood pressure measurements at home for 24 h using an automated non‐invasive ambulatory blood pressure measurement device. These blood pressures were compared with blood pressure measured before and during general anaesthesia in 18 subjects undergoing elective day surgery. We confirmed that a pre‐operative reading taken upon admission to hospital is significantly elevated compared to a usual daytime blood pressure in the same patient. The median (IQR [range]) increases in systolic and mean arterial pressures were 10 (2–15 [−5 to 59]) mmHg, p = 0.003 and 10 (5–14 [−5 to 35]) mmHg, p = 0.002, respectively. When using this admission blood pressure measurement as a ‘baseline’, systolic and mean arterial pressures decreased during sleep by 41 (30–46 [6–83]) mmHg and 34 (26–36 [6–58]) mmHg, respectively (p = 0.001). This decreased even further intra‐operatively: systolic blood pressure by 49 (36–64 [15–96]) mmHg and mean arterial pressure by 36 (26–46 [8–66]) mmHg (p = 0.001).