What question did this study set out to answer?

This research aims to compare individualized blood pressure control with standard methods during major gastrointestinal surgery and its effects on renal parameters.

January 20, 2026Open Access

Individualized vs. standard control of intraoperative blood pressure on serum creatinine profile and release of microRNA-21-5p after major gastrointestinal surgery in older patients with hypertension: a randomized controlled trial

Key Result

Individualized intraoperative blood pressure management attenuated the increase in postoperative creatinine levels in older patients with hypertension.

Key Points

This research aims to compare individualized blood pressure control with standard methods during major gastrointestinal surgery and its effects on renal parameters.
Conducted a randomized controlled trial
Involved older patients with hypertension undergoing major gastrointestinal surgery
Measured serum creatinine levels postoperatively
Assessed the release of microRNA-21-5p
Individualized blood pressure management significantly reduced microRNA-21-5p levels
Lower postoperative serum creatinine levels were observed in the individualized group
Indicated a potential for better renal outcomes with tailored blood pressure control

Structured PICO

Does individualized intraoperative blood pressure management reduce postoperative creatinine increase and microRNA-21-5p release in older patients with hypertension undergoing major gastrointestinal surgery?

Population

220 older patients (aged 65-80 years) with chronic hypertension scheduled for elective major gastrointestinal surgery (laparoscopic or open gastric cancer eradication or colorectal cancer surgery) under general anesthesia or anesthesia combined with regional nerve blockade, ASA classification I-III.

Intervention

Individualized intraoperative blood pressure management, with systolic blood pressure maintained at ± 10% or mean arterial pressure (MAP) maintained at ± 20% of baseline level via continuous administration of noradrenaline.

Comparator

Conventional intraoperative blood pressure management, with mean arterial pressure (MAP) maintained at 80-95 mmHg.

Outcome

Difference in serum creatinine (Cr) increase between the two groups, measured upon admission, at the end of surgery, and within 7 days of surgery.surrogate

Individualized intraoperative blood pressure management based on baseline levels attenuates postoperative renal function decline and microRNA-21-5p release in older hypertensive patients undergoing major gastrointestinal surgery.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Intraoperative individualized blood pressure management could reduce the release of microRNA-21-5p related to renal injury and attenuate the increase in postoperative creatinine levels in older patients with hypertension.

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