Original scientific paper

https://doi.org/10.20471/acc.2023.62.04.5

Predictors of Intraoperative Hypertension in Neck Surgery: a Single Center Retrospective Study

Tjaša Ivošević ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Belgrade, Serbia *
Biljana Miličić ; Department of Medical Statistics and Informatics, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
Aleksandar Trivić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Bojana Bukurov ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Nenad Arsović ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Nikola Slijepčević ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Hristina Ugrinović ; Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Belgrade, Serbia
Nemanja Radivojević ; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Nevena Kalezić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Belgrade, Serbia

* Corresponding author.

Abstract

Intraoperative hypertension (IOHTA) during neck surgery is undesirable because
this type of surgery has a propensity to bleed profoundly even in normotensive anesthesia. The purpose
of our study was to detect predictors of IOHTA in patients undergoing neck surgery. This single center
retrospective study included 880 adult patients who underwent neck surgery under general anesthesia.
The impact of gender, age, comorbidity, difficult tracheal intubation, anesthesia duration, and induced
hypotension on IOHTA was studied. IOHTA was present in 57 (6.7%) patients. The highest incidence
of IOHTA was recorded in patients with ASA 4 status and those with Cormack-Lehane grade 4,:
(22.2% and 21.4%, respectively). Significantly more patients with hypertension, hyperlipoproteinemia
and ventricular extrasystoles had IOHTA compared with patients without these comorbidities. Statistically
significant predictors of IOHTA were age (OR 1.438; 95% CI 1.144-1.808; p=0.002), cardiac
arrhythmia (OR 1.702; 95% CI 1.129-2.566; p=0.011), Cormack-Lehane grade (OR 1.407; 95% CI
1.054-1.878; p=0.020), and duration of anesthesia (OR 1.005; 95% CI 1.001-1.008; p=0.005). The risk
of IOHTA occurrence was lower in patients with induced hypotension (OR 0.024; 95% CI 0.003-0.185;
p=0.000). During neck surgery, special attention is needed in patients of older age, those with cardiac
arrhythmia, difficult intubation, and longer anesthesia duration because they are at risk of IOHTA.

Keywords

Hypertension; Intraoperative period

Hrčak ID:

320268

URI

https://hrcak.srce.hr/320268

Publication date:

31.12.2023.

Article data in other languages: croatian

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