Analysis of Blood Pressure Changes in Patients Undergoing Total Hip or Knee Replacement in Spinal and General Anesthesia

The aim of this study was to analyze hemodynamic changes in hypertensive and normotensive patients undergoing total hip or knee replacement in spinal and general anesthesia. Eighty patients who underwent total hip or knee replacement surgery in the period between July 2010 and February 2011 at Sveti Duh University Hospital were retrospectively evaluated. Seventeen patients underwent the operation in general anesthesia and 63 patients in regional anesthesia. They were allocated into groups of normotensive (n=24) or hypertensive patients (n=56). The anthropologic and hematologic parameters of normotensive and hypertensive patients were compared, as well as their blood pressures immediately before and during the operation. Blood pressure immediately before anesthesia induction, the highest and the lowest intraoperative blood pressures were recorded. Blood pressure immediately before anesthesia induction was significantly higher in hypertensive patients who underwent the operation in regional anesthesia compared to normotensive patients (158.48 mm Hg vs. 144.71 mm Hg, P<0.01). The highest intraoperative systolic blood pressure was also significantly higher in hypertensive patients operated on in regional anesthesia compared to normotensive patients (161.20 mm Hg vs. 146.76 mm Hg, P<0.01). The difference between the highest and the lowest intraoperative systolic blood pressure was significantly greater in hypertensive patients undergoing the operation in regional anesthesia compared to normotensive patients (46.41 mm Hg vs. 35.88 mm Hg, P<0.05). The results presented in this paper indicate that the fluctuations of intraoperative blood pressure were greater and the highest intraoperative systolic blood pressure was higher in hypertensive compared to normotensive patients undergoing the operation in regional anesthesia. In our study, there were no significant differences in intraoperative blood pressure between hypertensive and normotensive patients who underwent the opera
U ovom radu su analizirane hemodinamske promjene u hipertenzivnih i normotenzivnih bolesnika tijekom operacija ugradnje totalnih endoproteza kuka i koljena u općoj i regionalnoj anesteziji. Retrospektivno su analizirani podatci 80 bolesnika kojima je od srpnja 2010. do veljače 2011. u Kliničkoj bolnici Sveti Duh ugrađena totalna endoproteza kuka ili koljena. Sedamnaest bolesnika operirano je u općoj anesteziji, a 63 u regionalnoj. Njih 24 je svrstano u skupinu normotenzivnih, a 56 u skupinu hipertenzivnih bolesnika. Uspoređivani su njihovi antropološki i hematološki pokazatelji, kao i intraoperacijsko kretanje tlaka. Zabilježen je njihov arterijski tlak neposredno prije uvoda u anesteziju, te najviši i najniži tlak tijekom zahvata. Arterijski tlak neposredno prije uvoda u anesteziju bio je statistički značajno viši u hipertenzivnih bolesnika operiranih u regionalnoj anesteziji u odnosu na normotenzivne (158,48 mm Hg prema 144,71 mm Hg, P<0,01). Također najviši intraoperacijski sistolički tlak bio je statistički značajno viši u hipertenzivnih bolesnika operiranih u regionalnoj anesteziji u odnosu na normotenzivne (161,20 mm Hg prema 146,76 mm Hg, P<0,01). Razlika između najvišeg i najnižeg intraoperacijskog sistoličkog tlaka bila je statistički značajno viša u hipertenzivnih bolesnika operiranih u regionalnoj anesteziji u odnosu na normotenzivne (46,41 mm Hg prema 35,88 mm Hg, P<0,05). Rezultati izneseni u ovom radu govore u prilog tome da su kolebanja intraoperacijskog tlaka veća, te da je najviši intraoperacijski sistolički tlak viši u hipertenzivnih u odnosu na normotenzivne bolesnike operirane u regionalnoj anesteziji. Nisu pronađene statistički značajne razlike intraoperacijskog tlaka između hipertenzivnih i normotenzivnih bolesnika operiranih u općoj anesteziji.