Introduction
Intraoperative hypotension (IOH) during endoscopic procedures under general anesthesia is associated with adverse outcomes, including prolonged recovery and increased postoperative complications. However, its clinical impact remains underexplored (Sessler & Saugel, 2019). This study assesses the incidence, risk factors, and consequences of IOH in patients undergoing endoscopic procedures.
Aims & Methods
A prospective observational study was conducted on 1,100 patients undergoing various endoscopic procedures under general anesthesia over 12 months. Continuous hemodynamic monitoring was performed, and IOH was defined as a systolic blood pressure <90 mmHg or a ≥20% reduction from baseline (Bijker et al., 2009). Patient demographics, comorbidities, procedure duration, and clinical outcomes were analyzed. Multivariate regression identified independent risk factors and their association with postoperative complications, unplanned admissions, and recovery time.
Results
IOH occurred in 9.5% of patients and was significantly associated with age ≥40 years (p < 0.05), pre-existing hypertension (p < 0.01), and procedure duration >60 minutes (p < 0.05). Patients with IOH had prolonged recovery times (+45 minutes, p < 0.05), higher postoperative complications (21% vs. 9%, p < 0.01), and increased unplanned hospital admissions (15% vs. 5%, p < 0.01) (Smischney et al., 2015).
Conclusion
Intraoperative hypotension significantly affects patient outcomes, leading to prolonged recovery and increased postoperative morbidity. Early identification and hemodynamic optimization may reduce these risks, improving procedural safety and patient recovery (Brady et al., 2014).
References
1. Sessler DI, Saugel B. Beyond ‘systolic blood pressure’. Anesthesiology. 2019; 131(3):738-740.
2. Bijker JB, Persoon S, Peelen LM, et al. Intraoperative hypotension and 1-year mortality after noncardiac surgery. Anesthesiology. 2009; 111(6):1217-1226.
3. Smischney NJ, Pour-Ghaz I, Kaczmarek HE, et al. Intraoperative hypotension and risk of critical care admission after noncardiac surgery. Anesthesiology. 2015; 123(1):85-95.
4. Brady KM, Rhee CJ, Smielewski P, et al. Poor autoregulation and morbidity in pediatric traumatic brain injury. Pediatr Crit Care Med. 2014; 15(7):636-645.