Effect of Intraoperative Hypertension on Postoperative Pain Severity After Abdominal Hysterectomy: A Randomized Controlled Trial

Background: Pain is a common complain after surgeries, which leads to severe complications. Objectives: Elucidating the effect of intraoperative hypertension on post-operative pain after hysterectomy was the main aim of the current study. Methods: In this randomized controlled clinical trial that was conducted at Firoozgar Hospital, Tehran, Iran, 78 candidates for hysterectomy with past medical history of hypertension were randomly allocated to two groups. In group A, blood pressure was maintained in the range of stage 1 by dose adjustment of the anesthetic drugs. However, in group B, blood pressure was maintained in the normal range (SBP ≤ 120, DBP ≤ 80), by administration of anesthetic drugs and TNG drip. Preoperative and intra operative data (hematocrit, blood pressure, heart rate, operating time, and blood loss) and recovery data, including blood pressure, heart rate, pain score at two, four, six, 12, and 24 hours using VAS (after surgery), and pain relief medicine requirements after 24 hours were recorded for all patients and analyzed by SPSS 22.0. Results: Systolic and diastolic blood pressure before surgery did not show any significant differences (P ≥ 0.05). A significant decrease was found in systolic (P ≤ 0.001) and diastolic (P ≤ 0.014) blood pressure during surgery between groups. Comparing VAS and the need for pain relief drugs revealed no significant differences. However, a reduction of pain score was observed in the hypertensive group from the 2nd to 24th hour after surgery. Conclusions: No significant differences were shown between pain score and opioid requirement after surgery in hypertensive patients compared to normotensive during abdominal hysterectomy.