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September 19, 2016Arquivos Brasileiros de Neurocirurgia Brazilian NeurosurgeryOpen Access

Acute Arterial Hypertension in Patients undergoing Neurosurgery

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Key result

Perioperative hypertension in neurosurgery is a multifactorial condition primarily driven by sympathetic activation, requiring individualized pharmacological management to mitigate potential postoperative complications.

Population

Patients undergoing neurosurgery who develop perioperative acute arterial hypertension

Design

Review

Authors

NRNí­collas Nunes RabeloUniversidade de São PauloLFLuciano Silveira FilhoUniversidade de Ribeirão PretoGPGeorge Santos dos PassosHospital São Rafael

Discussion

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Overview

May inform individualized perioperative hypertension management in neurosurgery; leaves open optimal agent selection for prospective trials.

Structured PICO

P
Population
A literature review of 70 articles discussing the pathophysiology, diagnosis, and treatment of perioperative hypertension in patients undergoing neurosurgery.
I
Intervention
Antihypertensive pharmacological treatment (e.g., sodium nitroprusside, nitroglycerin, labetalol, esmolol, nicardipine, hydralazine, fenoldopam, enalaprilat, clonidine, captopril)
O
Outcome
Management of perioperative hypertension and prevention of complications such as intracranial hematomas

Perioperative hypertension is a common and potentially dangerous complication in neurosurgery that requires systematic evaluation of reversible causes and appropriate pharmacological intervention to prevent secondary neuronal injury and intracranial hemorrhage.

Limitations

  • Lack of prospective randomized trials demonstrating that aggressive management of acute postoperative hypertension improves clinical outcomes.
  • Inability of current studies to establish a cause-and-effect relationship between emergence hypertension and intracranial hemorrhage.

Cite This Study

Rabelo et al. (2016) conducted a review in Acute Arterial Hypertension in Neurosurgery. Antihypertensive management was evaluated. Perioperative hypertension in neurosurgery is a multifactorial condition primarily driven by sympathetic activation, requiring individualized pharmacological management to mitigate potential postoperative complications.

synapsesocial.com/papers/6a7078cd26a7f98052dcf8abhttps://doi.org/10.1055/s-0036-1592412
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Perioperative hypertension management2008 · 190 citations
  2. 2Hypertension in Perioperative Period1981 · 16 citations
  3. 3Dexmedetomidine for Neurological Surgery2005 · 247 citations
  4. 4A Prospective, Comparative Trial of Three Anesthetics for Elective Supratentorial Craniotomy1993 · 265 citations
  5. 5Anesthetic Effects on Blood—Brain Barrier Function during Acute Arterial Hypertension1978 · 43 citations