Key result
Systolic blood pressure was significantly higher inside the operating room just prior to surgery (135.73 mmHg) compared to earlier pre-anesthetic visits (P<0.001).
Why the study?
Preoperative blood pressure is highly variable, and it was unclear which preoperative measurement should serve as the reference baseline for intraoperative monitoring.
Which pre-operative blood pressure measurement time point provides the most accurate baseline reference for intraoperative monitoring in normotensive patients undergoing elective surgery?
Observational (n=260)
No
Which pre-operative blood pressure measurement time point provides the most accurate baseline reference for intraoperative monitoring in normotensive patients undergoing elective surgery?
Absolute Event Rate: 135.73% vs 118.18%
p-value: p=<0.001
Blood pressure measured one day prior to surgery in the ward (PAC2) is the lowest and may serve as an ideal reference baseline, as blood pressure measured inside the operating room is significantly elevated due to stress.
Pre-op OT SBP may overestimate baseline due to stress; leaves open optimal timing for accurate reference values in elective surgery monitoring.
Background: Blood pressure (BP) is volatile in nature and also it affects post-operative outcomes therefore, regular perioperative BP monitoring is essential. Intraoperative variability of BP is permitted in range and proportion to baseline BP according to various guidelines. Pre-operatively BP is measured many times and it is highly variable. In this study we attempt to predict which pre-operative BP can be used as reference during intraoperative monitoring. Methods: This observational study was conducted at hamidia hospital, Bhopal. 260 normotensive patients undergoing elective surgery who got clearance during PAC were enrolled. BP was measured by gold standard mercury sphygmomanometer in PAC clinic (PAC1), review PAC one day prior to surgery (PAC2), morning BP in preoperative room (POR) and inside OT room (IOR) before surgery. Results: In 260 enrolled patients males were slightly predominant 52.31%. Mean age was 34.68±11.63 years. Mean of Systolic BP (SBP) during PAC1, PAC2, Morning BP in POR and IOR prior surgery were 122.85±8.24, 118.18±8.08, 123.06±8.24 and 135.73±10.24 respectively and was significant (P<0.001). Mean of heart rate (HR/minute) during PAC1, PAC2, Morning BP in POR and IOR prior surgery were 79.77±7.22, 78.90±7.44, 80.40±7.49 and 89.15±7.60 respectively and was significant (P<0.001). Conclusions: Aaaaaa Due to stress of surgery SBP and HR were significantly higher in IOR just prior surgery. Also, BP of PAC2 at ward was lowest though not significantly lower than BP in PAC1 or POR. Thus, BP of PAC2 can be used as an ideal reference BP but larger study is required for further generalization.
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Kundnani et al. (2021) conducted an observational in Normotensive patients undergoing elective surgery (n=260). Blood pressure measurement inside the operating room (IOR) vs. Blood pressure measurement at pre-anesthetic clinic (PAC1, PAC2) and preoperative room (POR) was evaluated on Mean Systolic Blood Pressure (p=<0.001). Systolic blood pressure was significantly higher inside the operating room just prior to surgery (135.73 mmHg) compared to earlier pre-anesthetic visits (P<0.001).
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