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Perioperative hypertension At least 25% of hypertensive patients who undergo noncardiac surgery develop myocardial ischemia associated with the induction of anaesthesia or during the intraoperative or early post-anaesthesia period.
stuck valve, hypoventilation, soda lime exhaustion and endobronchial intubation) were 13% of incidents.
Criteria for hypertensive emergencies (crises) include: dissecting aortic aneurysm, acute left ventricular failure with pulmonary oedema, acute myocardial ischemia, eclampsia, acute renal failure, symptomatic microangiopathic haemolytic anemia and hypertensive encephalopathy.
Causes of hypertensive crises Cessation of antihypertensive medications is one of the main causes.
It is usually successfully controlled by anaesthetists.
However, there is a lack of agreement concerning treatment plans and appropriate therapeutic goals, making common management protocols difficult.
The long term end-organ effects add to patient morbidity and mortality.
Ensuring cardiovascular stability and pre-optimization of BP allows safe manipulation of physiology and pharmacology during anaesthesia.The absolute level of BP is as important as the rate of increase.For example, patients with chronic hypertension may tolerate systolic BPs (SBP) of 200 mm Hg without developing hypertensive encephalopathy, while pregnant women and children may develop encephalopathy with diastolic BPs of 100 mm Hg.A wide range of pharmacological alternatives are available to control blood pressure and reduce the risk of complications in these patients.This article reviews the perioperative hypertensive crisis and the common strategies used in management.Perioperative hypertension commonly occurs in patients undergoing surgery.