Hypertension management before, during, and after surgery

Anticipating surgery can be an anxious time. If you have high blood pressure (also called high blood pressure), you may have additional concerns about how your general anesthesia will respond.

Ideally, your blood pressure will return to normal a few months before surgery. While the study found that “mild to moderate diastolic or systolic hypertension did not increase a patient’s risk of surgery,” high blood pressure may “increase surgical risk and must be carefully controlled prior to surgery.”

This article outlines what to expect before, during, and after surgery if you have high blood pressure.

Before surgery

If you have high blood pressure, surgery may put you at risk for:

  • congestive heart failure
  • heart attack
  • kidney problems
  • stroke

In general, risk increases with blood pressure readings. That said, high blood pressure is usually not a reason to delay surgery unless a person is undergoing elective major surgery and has poorly controlled blood pressure. This means a systolic blood pressure of 180 mmHg or higher or a diastolic blood pressure of 110 mmHg or higher. In this case, it might be a good idea to postpone the surgery, as normal pressure is 120/80 mmHg.

It is important to follow your healthcare team’s instructions on which medicines to keep and which to stop before surgery.

For people with chronic high blood pressure, continuous use of high blood pressure medications (called antihypertensives) is generally safe in most cases. In fact, stopping some of these may cause a rebound effect that increases blood pressure.

However, some high blood pressure medications (such as ACE inhibitors or angiotensin receptor blockers) are withheld for a period of time, such as 24 hours, before surgery. Finally, be sure to Discuss with your healthcare provider what medicines you should and should not take before surgery. Every patient is different, as is their medical history. Your provider should know you and your history like the back of their own hand.

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During surgery

Before you enter the operating room, your anaesthetist will ask you some questions about your medical history, in addition to reviewing your medical history. This way, they will learn about your baseline blood pressure, drug allergies and/or previous reactions to anesthesia.

During surgery, the anesthesiologist will keep a close eye on your blood pressure and other vital signs, such as your heart rate and breathing rate. Blood pressure changes during surgery are normal and can be caused by a variety of factors. For example, your blood pressure may rise during surgery due to the activation of the sympathetic nervous system when anesthesia begins – this is normal. At the same time, your heart rate may also rise.

To treat high blood pressure during surgery, your anaesthetist may administer an IV (through your vein) antihypertensive drugs (or high blood pressure medication).

On the other hand, if you lose blood during surgery, your blood pressure may drop. You may only need fluids and/or blood transfusions to increase your blood pressure.However, if there is severe blood loss (meaning more than 20% of your body’s blood supply) during surgery, a life-threatening condition called hypovolemia Shock (meaning a drop in blood volume) may occur.

Hypovolemic shock occurs when blood loss makes it difficult for the heart to beat normally, which in turn reduces the amount of blood entering major organs. This type of shock requires an emergency blood change to make sure your organs get the oxygen they need to function.

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Anesthesiologists do more than just administer anesthesia before surgery. Their job is to closely monitor your blood pressure and respond accordingly if it’s too high or too low.

after surgery

Your blood pressure and heart rate may increase slowly and naturally as you recover from anesthesia. If you have significant high blood pressure after surgery (when your systolic blood pressure is 180 mmHg or higher), you may receive intravenous medication (rather than oral medication) to lower your blood pressure.

On the other hand, some people experience a drop in blood pressure after surgery. This may be due to medications given by the anesthesiologist (such as pain relievers) or simply a side effect of the surgery.

You should also know that your blood pressure may experience a dangerous and life-threatening drop after surgery due to infection. To prevent or treat potential infections, your healthcare provider may give you antibiotics before and after surgery.

generalize

In general, surgery risks increase as your blood pressure rises. That said, high blood pressure is usually not a reason to delay surgery unless you are undergoing elective major surgery or have poorly controlled blood pressure. For people with chronic high blood pressure, continuous use of high blood pressure medication is generally safe in most cases. In fact, stopping some of these may cause a rebound effect that increases blood pressure. However, some high blood pressure medications (such as ACE inhibitors or angiotensin receptor blockers) are withheld for a period of time, such as 24 hours, before surgery.

During the procedure, the anesthesiologist will keep a close eye on your blood pressure and other vital signs. As you recover from anesthesia after surgery, your blood pressure and heart rate may increase slowly and naturally. You should be aware that your blood pressure may experience a dangerous and life-threatening drop after surgery due to infection. To prevent or treat potential infections, your healthcare provider may give you antibiotics before and after surgery.

Finally, be sure to Discuss with your healthcare provider what medicines you should and should not take before surgery. Every patient is different, as is their medical history. Therefore, their preoperative and postoperative guidance will also vary.

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Knowing all this, you’ll see why people say follow doctor’s advice forward Surgery may be more important than following postoperative instructions. (In fact, they’re all important, but preoperative guidance directly affects what’s going on during surgery.) It may also be reassuring to meet with an anesthesiologist before surgery and ask any questions you may have. No one Being able to predict exactly what will happen as your surgery progresses, but knowing the stps involved and knowing that your medical team is skilled and proactive should take away your preoperative anxiety.

Frequently Asked Questions

  • Does high blood pressure increase the risk of surgical complications?

    Yes. If you are diagnosed with high blood pressure, you are at increased risk of complications from surgery. Possible complications include congestive heart failure, heart attack, kidney problems and stroke. Treating high blood pressure before surgery may help reduce your risk.

  • How is blood pressure monitored during surgery?

    Your blood pressure will be continuously monitored during the procedure sphygmomanometer (blood pressure cuff). Your anaesthetist will monitor your blood pressure and give intravenous medication as needed to regulate your blood pressure.

  • What happens to blood pressure after surgery?

    Monitor your blood pressure closely immediately after surgery. If your blood pressure is high, you may be given intravenous medication to lower your blood pressure.