Abstract

Arterial hypertension is one of the most common co-morbid conditions affecting general population, which contributes to pathogenesis of various diseases worsening the treatment outcome. Aim: The aim of this study was to observe peri-operative hemodynamic parameters in hypertensive geriatric patients posted for lower limb orthopaedic surgery under spinal anaesthesia. Methods: A prospective observational study conducted at Bone and Joint Hospital, an associated hospital of GMC Srinagar after approval by Institutional Ethical Committee. 60 patients in total which were divided into two groups, controlled Hypertension (28 patient with systolic blood pressure between 120 to 139 mmHg and diastolic blood pressure between 80 to 89 mmHg, and, uncontrolled hypertension (32 patients with systolic blood pressure between >140 mmHg and diastolic blood pressure between >90 mmHg). The pre-operative assessment of patients including thorough history, particularly regarding known cases of hypertension and its duration or newly detected cases, use of anti-hypertensive medications, history of other co-morbid diseases, previous anaesthetic exposure, any other drug history, allergy to any drug and personal habits were elicited. Peri-operative complications (bradycardia, tachycardia, hypertension, hypotension, arrhythmias, myocardial ischaemia, cerebrovascular accidents heart failure etc.) were also noted. Results: There were 46.66% (n=28) patients who had controlled hypertension while as uncontrolled hypertension was seen in 53.55% (n=32) patients. Significant statistical difference was obtained when intraoperative MAP was correlated with two study groups at 10 to 40 minutes and at 70 minutes. At all other time intervals the difference was insignificant. Hypotension was seen more in uncontrolled hypertension (84.37%) compared to patients who had controlled hypertension (28.57%). The difference observed was statistically significant (p 0.00001).

Description