Arteriosclerosis can predict hypotension during anesthesia induction in patients 40 years and older

Yoshinari Morimoto; Kazuaki Yamagata; Hiroshi Hanamoto; Aiji Boku; Chiho Kudo; Chizuko Yokoe; Mitsutaka Sugimura; Hitoshi Niwa

doi:10.1016/j.jclinane.2014.06.011

Arteriosclerosis can predict hypotension during anesthesia induction in patients 40 years and older

J Clin Anesth. 2014 Nov 26:S0952-8180(14)00329-8. doi: 10.1016/j.jclinane.2014.06.011. Online ahead of print.

Authors

Yoshinari Morimoto¹, Kazuaki Yamagata², Hiroshi Hanamoto², Aiji Boku², Chiho Kudo², Chizuko Yokoe², Mitsutaka Sugimura², Hitoshi Niwa²

Affiliations

¹ Special Patient Oral Care Unit, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan; Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: ysn-mori@dent.kyushu-u.ac.jp.
² Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan.

PMID: 25432581
DOI: 10.1016/j.jclinane.2014.06.011

Abstract

Study objectives: To identify the factors that predict blood pressure (BP) changes during induction of general anesthesia, and the relationship between the level of arteriosclerosis and BP changes during anesthesia induction.

Design: Prospective, case-control observational study.

Settings: Operating room of a university hospital.

Patients: Seventy-two patients who received general anesthesia for oral and maxillofacial surgery.

Measurements: Brachial-ankle pulse wave velocity (baPWV) and central BP were measured. The primary variable was the parameters affecting BP changes during the induction of general anesthesia. For additional analyses, the parameters were compared between high and low PWV groups (1606 cm/s was the cutoff value of baPWV). To measure the relationships between the parameters and BP changes, bivariate and multiple linear regression analyses were performed.

Results: Seventy-two patients (including 41 men) with a mean age of 61.7 years and a median baPWV value of 1606 cm/s were evaluated. Significantly higher values for age, central BP, preoperative systolic BP (SBP), amount of decrease in SBP and diastolic BP, and number of patients with diabetes mellitus (DM) and hypertension were observed in the high PWV group. Multiple linear regression analysis demonstrated that age, baPWV, and DM were factors independently associated with the amount of decrease in SBP.

Conclusion: In patients 40 years and older, age, baPWV, and DM are thought to be effective predictors of the amount of decrease in SBP during induction of general anesthesia.

Keywords: Age; Arteriosclerosis; Brachial-ankle pulse wave velocity (baPWV); Diabetes mellitus; General anesthesia; Hypotension.