Ondrej Jor1,2, Jan Maca3,4, Jirina Koutna5,6, Michaela Gemrotova7, Tomas Vymazal8, Martina Litschmannova9, Pavel Sevcik3,4, Petr Reimer3, Vera Mikulova4, Michaela Trlicova4, Vladimir Cerny10,11,12,13. 1. Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, 17. listopadu 1790, Poruba, 708 52, Ostrava, Czech Republic. ondra_jor@centrum.cz. 2. Department of Anesthesiology and Intensive Care, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Prague, Czech Republic. ondra_jor@centrum.cz. 3. Department of Anesthesiology and Intensive Care Medicine, University Hospital Ostrava, 17. listopadu 1790, Poruba, 708 52, Ostrava, Czech Republic. 4. Department of Intensive Medicine and Forensic Studies, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic. 5. Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Olomouc, Czech Republic. 6. Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic. 7. Department of Anesthesia and Resuscitation, Novy Jicin Hospital, Novy Jicin, Czech Republic. 8. Department of Anesthesiology and Intensive Care Medicine, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic. 9. Department of Applied Mathematics, Technical University of Ostrava, Ostrava, Czech Republic. 10. Department of Anesthesiology, Perioperative Medicine and Intensive Care, J.E. Purkinje University, Masaryk Hospital, Usti nad Labem, Czech Republic. 11. Centrum for Research and Development, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic. 12. Department of Anesthesiology and Intensive Care, Faculty of Medicine in Hradec Kralove, Charles University in Prague, Prague, Czech Republic. 13. Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
Abstract
BACKGROUND: Hypotension after induction of general anesthesia (GAIH) is common in anesthesiology practice and can impact outcomes. METHODS: In this prospective multicenter, cross-sectional, observational study, the hypotension was defined as a decrease in mean arterial pressure of > 30% compared to the first measurement in the operation theatre before general anesthesia (GA) induction. Blood pressure was measured immediately at the time of endotracheal intubation (TETI), at five (T5) and 10 (T10) minutes after. All subjects aged > 18 years undergoing elective non-cardiac surgery under GA were included. The goals were description of GAIH occurrence, the association of GAIH with selected comorbidities, chronic medications, and anesthetics with GAIH, and the type and efficacy of interventions used to correct hypotension. RESULTS: Data from 661 subjects, whose GA was induced with propofol and sufentanil, were analyzed. In 36.5% of subjects, GAIH was observed at ≥ 1 of the assessed time points. GAIH was present in 2.9% subjects at all time points. The probability of GAIH is raising with age, degree of hypertension at time of arrival to theatre and presence of diabetes. The type of volatile anesthetic was not associated with the occurrence of GAIH. The overall efficiency of interventions to correct hypotension was 94.4%. Bolus fluids were the most often used intervention and was 96.4% effective. CONCLUSION: GAIH rate depends on age, degree of blood pressure decompensation prior the surgery, and presence of diabetes mellitus type II.
BACKGROUND:Hypotension after induction of general anesthesia (GAIH) is common in anesthesiology practice and can impact outcomes. METHODS: In this prospective multicenter, cross-sectional, observational study, the hypotension was defined as a decrease in mean arterial pressure of > 30% compared to the first measurement in the operation theatre before general anesthesia (GA) induction. Blood pressure was measured immediately at the time of endotracheal intubation (TETI), at five (T5) and 10 (T10) minutes after. All subjects aged > 18 years undergoing elective non-cardiac surgery under GA were included. The goals were description of GAIH occurrence, the association of GAIH with selected comorbidities, chronic medications, and anesthetics with GAIH, and the type and efficacy of interventions used to correct hypotension. RESULTS: Data from 661 subjects, whose GA was induced with propofol and sufentanil, were analyzed. In 36.5% of subjects, GAIH was observed at ≥ 1 of the assessed time points. GAIH was present in 2.9% subjects at all time points. The probability of GAIH is raising with age, degree of hypertension at time of arrival to theatre and presence of diabetes. The type of volatile anesthetic was not associated with the occurrence of GAIH. The overall efficiency of interventions to correct hypotension was 94.4%. Bolus fluids were the most often used intervention and was 96.4% effective. CONCLUSION: GAIH rate depends on age, degree of blood pressure decompensation prior the surgery, and presence of diabetes mellitus type II.
Entities:
Keywords:
Anesthesia induction; General anesthesia; Hypotension; Predictors; Risk factors
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