Blood pressure: Continuous monitoring helps stabilization
Intraoperative hypotension is a frequent occurrence in patients undergoing general anesthesia, and it is associated with adverse outcomes such as postoperative acute kidney failure, myocardial infarction or stroke. Patients with history of chronic hypertension are particularly susceptible, warn researchers at the University Hospital Munich. They also point out that since a patient's blood pressure (BP) is generally monitored intermittently via an upper arm cuff, detection of hypotension by the anesthetist might be delayed. Could a continuous BP monitoring help to improve BP stability? The results certainly indicate it.
The randomized, controlled study included 160 orthopedic patients with a history of chronic hypertension undergoing surgery. The patients were randomized to either continuous non-invasive BP monitoring in addition to oscillometric intermittent monitoring (n=77) or to intermittent BP monitoring only (control group, n = 83). The baseline BP was not significantly different between the groups. Main outcome measures were BP stability and hypotensive events.
The mean arterial BP in the study group was significantly higher than in the control group both at 12 minutes and at 15 minutes: 102 vs. 90 mmHg (P = 0.039) and 102 vs. 90 mmHg (P = 0.023), respectively. Hypotensive readings below a mean pressure of 55 mmHg were observed more often in the control group (25 vs. 7, P = 0.047).
In this population, BP stability was increased through continuous monitoring, summarize the authors.