Intraoperative Hypotension and Post-anesthesia Care Unit Recovery

Study Overview
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Brief Summary
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The underlying causative mechanism that leads to intraoperative hypotension (IOH) may vary depending on the stage of anesthesia and surgery, which determines different IOH types. Naturally, the incidence and severity of IOH types will differ, as will the incidence and severity of postoperative complications.

Detailed Description
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Background The underlying causative mechanism that leads to intraoperative hypotension (IOH) may vary depending on the stage of anesthesia and surgery, which determines different IOH types. Naturally, the incidence and severity of IOH types will differ, as will the incidence and severity of postoperative complications. Methods The investigators conducted a data-based observational study that included 4776 patients. Post-induction hypotension (pIOH) is defined as a decrease during the first 20 min after anesthesia induction and maintenance intraoperative hypotension (mIOH) when there is a decrease of blood pressure 20th min after induction, with or without pIOH.

Official Title
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Different Types of Intraoperative Hypotension and Their Association With Post-anesthesia Care Unit Recovery

Conditions
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Post-induction Hypotension, Post Anesthesia Recovery, Hypotension, Intraoperative Hypotension

Intervention / Treatment
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* Other: Hemodynamic observation of the patients.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years and older Underwent elective surgery Received general anesthesia Planned overnight stay in the hospital after surgery Exclusion Criteria: Under 18 years of age Cardiac surgery Transplant surgery Preoperatively receiving vasoactive drugs Patients with mechanical circulatory support Pediatric surgery Patients from ICU Patients with scheduled postoperative ICU admissions

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Post-induction hypotension<br>Post-induction hypotension (pIOH) is a decrease during the first 20 min after anesthesia induction | Other: Hemodynamic observation of the patients.<br>* For the purposes of this study, we defined intraoperative hypotension as a decrease in mean blood pressure of 30% from baseline for a minimum of 5 minutes, including induction and maintenance of anesthesia. The measuring blood pressure method (noninvasive or invasive) depended on the surgical intervention's invasiveness and the patient's cardiac performance. As soon as the patients entered the PACU, the responsible nurses started the standard monitoring. Anesthesiologists constantly oversee all actions based on the patient's condition. Clinical observation for respiratory and gastrointestinal problems and all disorders were monitored. When in room air SO2 was <94, we started oxygen treatment with a 4 liter/minute nasal cannula, and in cases of nausea antiemetic was administered. The Modified Aldrete Score was used to discharge the patent.<br>* Other names: Postoperative clinical observation;|
| Maintenance intraoperative hypotension<br>maintenance intraoperative hypotension (mIOH) when there is a decrease of blood pressure 20th min after induction, with or without pIOH | Other: Hemodynamic observation of the patients.<br>* For the purposes of this study, we defined intraoperative hypotension as a decrease in mean blood pressure of 30% from baseline for a minimum of 5 minutes, including induction and maintenance of anesthesia. The measuring blood pressure method (noninvasive or invasive) depended on the surgical intervention's invasiveness and the patient's cardiac performance. As soon as the patients entered the PACU, the responsible nurses started the standard monitoring. Anesthesiologists constantly oversee all actions based on the patient's condition. Clinical observation for respiratory and gastrointestinal problems and all disorders were monitored. When in room air SO2 was <94, we started oxygen treatment with a 4 liter/minute nasal cannula, and in cases of nausea antiemetic was administered. The Modified Aldrete Score was used to discharge the patent.<br>* Other names: Postoperative clinical observation;|
| Normotensive patients<br>Patients with normotension during surgery. | Other: Hemodynamic observation of the patients.<br>* For the purposes of this study, we defined intraoperative hypotension as a decrease in mean blood pressure of 30% from baseline for a minimum of 5 minutes, including induction and maintenance of anesthesia. The measuring blood pressure method (noninvasive or invasive) depended on the surgical intervention's invasiveness and the patient's cardiac performance. As soon as the patients entered the PACU, the responsible nurses started the standard monitoring. Anesthesiologists constantly oversee all actions based on the patient's condition. Clinical observation for respiratory and gastrointestinal problems and all disorders were monitored. When in room air SO2 was <94, we started oxygen treatment with a 4 liter/minute nasal cannula, and in cases of nausea antiemetic was administered. The Modified Aldrete Score was used to discharge the patent.<br>* Other names: Postoperative clinical observation;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of IOH types on PACU recovery (Duration) | The underlying causative mechanism that leads to IOH may vary depending on the stage of anesthesia and surgery, which determines different IOH types; therefore recovery after them will differ. care unit (PACU) recovery, especially duration and complications in the PACU. | From the preoperative first monitorization of the patient in the operating room until until discharege from the PACU (0-720 minutes). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PACU recovery | Compare the effect of intraoperative hypotension types on PACU recovery to the effect of other factors influencing PACU recovery. | Postoperatively from the patient's arrival to the PACU until discharge (0-240 minutes). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Complication, Intraoperative Hypotension, PACU outcomes, PACU recovery, Hypotension