Audit of Intraoperative Hypertension Management in 75 Patients at THQ Hospital Sadiq Abad

Background: Intraoperative hypertension (IOH) is a frequent anesthetic challenge linked to myocardial ischemia, arrhythmias, cerebrovascular events, and increased surgical bleeding. Despite its impact, structured evaluation of IOH management is inconsistent, especially in resource limited hospitals. Objective: To evaluate recognition, documentation, precipitating causes, and management of IOH at THQ Hospital Sadiq Abad, and to identify gaps relative to accepted standards. Methods: A retrospective audit of 75 adult patients (18,75 years) with documented IOH episodes from January to June 2025 was conducted. Data extracted from anesthesia records included demographics, ASA grade, type of surgery, anesthetic technique, recorded trigger(s), interventions, and outcomes. Audit standards were adapted from the Association of Anaesthetists perioperative hypertension guidance. Results: IOH was documented in all 75 cases (100%). The most common firstline response was deepening anesthesia (42%), followed by opioid boluses (28%) and antihypertensives (16%). Conclusion: Recognition of IOH was universal, but documentation of triggers and protocolized management were suboptimal. Structured proformas and focused teaching followed by reaudit may improve patient safety.