Impact of intraoperative hypotension and blood pressure fluctuations on early postoperative delirium after laparoscopic surgery
10.3760/cma.j.issn.1008-1372.2016.07.016
- VernacularTitle:术中低血压和血压波动对老年患者外科腹腔镜术后早期谵妄的影响
- Author:
Jie JI
;
Lin FU
;
Xuan GUO
- Publication Type:Journal Article
- Keywords:
Intraoperative complications;
Hypotension;
Blood pressure;
Laparoscopy;
Postoperative complications;
Delirium/ET
- From:
Journal of Chinese Physician
2016;18(7):1017-1020
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate whether intraoperative hypotension was associated with postoperative delirium in older patients undergoing laparoscopic surgery with prospective cohort study.Methods Study subjects were patients,＞ 65 years of age,undergoing laparoscopic surgery,who were enrolled in an ongoing prospective observational study of the pathophysiology of postoperative delirium.Intraoperative blood pressure was measured,and predefined criteria were used to define hypotension.Delirium was measured by the Confusion Assessment Method on the first two postoperative days.Data were analyzed with t-test,two-sample proportion test,and ordered logistic regression muhivariable model,including correction for multiple comparison.Results Data from 213 patients with a mean age of 73.6 years (SD 6.1) were studied.Of these 63 (29.6％) developed delirium on day 1 and 61 (28.6％) on day 2.Relative hypotension (decreases by 20％,30％,or 40％) or absolute hypotension [mean arterial pressure (MAP) ＜ 50mmHg] were not significantly associated with postoperative delirium,nor was the duration of hypotension (MAP ＜ 50 mmHg).Conversely,intraoperative blood pressure variance was significantly associated with postoperative delirium.Conclusions These results showed that increased blood pressure fluctuation,not absolute or relative hypotension,was predictive of postoperative delirium.
