Authors: Jarosław Miłoński, Joanna Urbaniak, Hanna Zielińska-Bliźniewska, Jurek Olszewski
Otolaryngologia polska. The Polish otolaryngology. 09/2011; 65(5):357-62.
This work aimed to analyse the mean arterial blood pressure (MBP) and heart rate (HR) in patients who underwent laryngological surgery within the preoperative, perioperative and postoperativeThis work aimed to analyse the mean arterial blood pressure (MBP) and heart rate (HR) in patients who underwent laryngological surgery within the preoperative, perioperative and postoperative periods.
The study covered 502 patients, including 209 women and 293 men, aged 18-85, who were divided into 6 groups according to the type of surgery: I - FESS (Functional Endoscopic Sinus Surgery), II - septoplasty, III - endoscopic re-operation of the paranasal sinuses, IV - microlaryngoscopy, V - tonsillectomy, VI - middle ear surgery. Only the patients with BP below 140/90 mmHg and maximum class 2 in the ASA scale were qualified for the surgical procedure. On admission, the arterial blood pressure was measured and diagnostic investigations like FBC, blood grouping determination, coagulogram, ESR, CRP and imaging studies were performed in each patient. Every operation was conducted under TIVA. BT and HR were monitored during an operation as well as through the four following hours in a recovery room.
The youngest group of patients with chronic palatine tonsillitis showed the lowest pressure values while the oldest studied group consisted of patients who were operated due to chronic otitis media and this group demonstrated the highest BP values. The patients with treated or untreated hypertension should be pharmacologically normalised by an anaesthesiologist. However, considerable lowering of BP can often be not possible, contrary to the patients with normal BP.
The own experience indicates that perioperative lowering of BP, including hypotension, ought to be avoided in cardiology patients. The postoperative BP raise, usually accompanied by pain, was noticed in the own studies. Therefore, effective analgesic treatment should be implemented in a recovery room.
