IMPACT OF ANESTHESIA ON BLOOD PRESSURE CONTROL IN HYPERTENSIVE PATIENTS DURING GENERAL SURGERY.

JPUMHS;2024:14:04,145-151.http://doi.org/10.46536/jpumhs/2024/14.04.572

Abstract

BACKGROUND: Hypertension is a significant risk factor for increased mortality during
anesthesia. Withdrawal from antihypertensive medications can lead to complications like
anxiety, rebound hypertension, myocardial infarction, and death. OBJECTIVE: This study
aimed to evaluate the effects of anesthesia on perioperative blood pressure management in
hypertensive patients undergoing general surgeries. METHODOLOGY: A prospective
observational study was conducted at federal government Polyclinic hospital PGMI, from
April 2023 to March 2024. Seventy hypertensive patients aged 40–65 years undergoing
elective general surgery under general anesthesia were included. BP was measured
preoperatively, intraoperatively, and postoperatively, with fluctuations recorded. Key factors
observed included blood loss, anesthesia drugs, haemodynamics heart rate, systolic and
diastolic blood pressure, antihypertensive medication use, and fluid consumption. SPSS
version 27 was used for data analysis. RESULTS: The mean patient age was 56.4 ± 8.7
years, with 65% males. Pre-induction SBP was 145.9 ± 10.6 mmHg and DBP 90.5 ± 7.3
mmHg. Intraoperative BP dropped significantly, with a mean SBP decrease of 18.5 mmHg p
< 0.01. Hypotension occurred in 35% of patients, requiring vasopressors, while 12%
experienced hypertension. Postoperative BP stabilized in 65% of patients. Beta blocker use
was significantly associated with lower postoperative heart rates p = 0.034, while diuretics
showed a trend toward lower heart rates but did not reach significance. CONCLUSION:
General anesthesia led to significant BP fluctuations in hypertensive patients, with 35%
experiencing hypotension. Beta blocker use was effective in controlling postoperative heart
rate.