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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Dental Medicine / Faculty of Dental Medicine >
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Predictors of hypotension during anesthesia induction in patients with hypertension on medication : a retrospective observational study
| Title: | Predictors of hypotension during anesthesia induction in patients with hypertension on medication : a retrospective observational study |
| Authors: | Hojo, Takayuki Browse this author →KAKEN DB | | Kimura, Yukifumi Browse this author →KAKEN DB | | Shibuya, Makiko Browse this author →KAKEN DB | | Fujisawa, Toshiaki Browse this author →KAKEN DB |
| Keywords: | Anesthesia Induction | | General anesthesia | | Hypotension | | Antihypertensive medication | | Predictor | | Half-life |
| Issue Date: | 11-Nov-2022 |
| Publisher: | BioMed Central |
| Journal Title: | BMC Anesthesiology |
| Volume: | 22 |
| Issue: | 1 |
| Start Page: | 343 |
| Publisher DOI: | 10.1186/s12871-022-01899-9 |
| PMID: | 36368916 |
| Abstract: | Background Hypotension during anesthesia induction is a common event, and occurs more frequently in patients with hypertension than in healthy individuals. Intraoperative hypotension in non-cardiac surgery is reportedly associated with various postoperative complications. However, the predictors of hypotension during anesthesia induction in patients with hypertension have not yet been ascertained. Therefore, we aimed to determine the predictors of hypotension during anesthesia induction in patients with hypertension on medication focusing on the half-life of the medication used. Methods In this retrospective observational study, we enrolled patients with hypertension on medication who underwent general anesthesia for oral and maxillofacial surgery between January 1, 2013, and December 31, 2019. Multivariable logistic regression analysis was conducted to test for associations between clinical factors and hypotension during anesthesia induction in patients with hypertension on medication. Results A total of 395 patients were included in this study. The risk factors for hypotension during anesthesia induction in patients with hypertension on medication were pre-induction mean arterial blood pressure (adjusted unit odds ratio, 0.96 [95% confidence interval, 0.94 to 0.98]), female sex (adjusted odds ratio [aOR], 1.63 [1.03 to 2.57]), regular use of angiotensin receptor blockers (ARBs)/angiotensin-converting enzyme inhibitors (ACE-Is) with a long half-life (vs. no regular use of ARBs/ACE-Is aOR, 4.02 [1.77 to 9.12]; vs. regular use of ARBs/ACE-Is with a short-to-middle half-life aOR, 3.17 [1.46 to 6.85]), and regular use of beta blockers (aOR, 2.45 [1.19 to 5.04]). Regular use of calcium channel blockers (aOR, 0.44 [0.25 to 0.77]) was a suppressive factor for hypotension during anesthesia induction in patients with hypertension. Conclusions In patients with hypertension on medication, regular use of ARBs/ACE-Is with a long half-life, regular use of beta blockers, low pre-induction mean arterial blood pressure, and female sex were risk factors for hypotension during anesthesia induction. Notably, regular use of ARBs/ACE-Is with a long half-life was a high-risk factor for hypotension during anesthesia induction in patients with hypertension on medication even after a 24-h preoperative withdrawal period. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/87808 |
| Appears in Collections: | 歯学院・歯学研究院 (Graduate School of Dental Medicine / Faculty of Dental Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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