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Defining intra-operative hypotension - a pilot comparison of blood pressure during sleep and general anaesthesia*
MedLine Citation:
PMID:  21418042     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The scientific justification for particular values of intra-operative hypotension is poorly substantiated. To provide a rationale for appropriate values we recorded blood pressure measurements at home for 24 h using an automated non-invasive ambulatory blood pressure measurement device. These blood pressures were compared with blood pressure measured before and during general anaesthesia in 18 subjects undergoing elective day surgery. We confirmed that a pre-operative reading taken upon admission to hospital is significantly elevated compared to a usual daytime blood pressure in the same patient. The median (IQR [range]) increases in systolic and mean arterial pressures were 10 (2-15 [-5 to 59]) mmHg, p = 0.003 and 10 (5-14 [-5 to 35]) mmHg, p = 0.002, respectively. When using this admission blood pressure measurement as a 'baseline', systolic and mean arterial pressures decreased during sleep by 41 (30-46 [6-83]) mmHg and 34 (26-36 [6-58]) mmHg, respectively (p = 0.001). This decreased even further intra-operatively: systolic blood pressure by 49 (36-64 [15-96]) mmHg and mean arterial pressure by 36 (26-46 [8-66]) mmHg (p = 0.001).
Authors:
J C L Soo; S Lacey; R Kluger; B S Silbert
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-18
Journal Detail:
Title:  Anaesthesia     Volume:  -     ISSN:  1365-2044     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.
Affiliation:
 Anaesthetic Registrar  Staff Anaesthetist  Senior Staff Anaesthetist, St Vincent's Hospital, Melbourne, Victoria, Australia.
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