Neuroanesthesia & neurocritical care
Associations between intraoperative hypotension and postoperative seizures following craniotomy for brain tumor resection
Authors' conclusion
Intraoperative hypotension was independently associated with postoperative seizures after brain tumor resection. Moreover, both the severity and duration of hypotension showed dose-response relationships.
Study context
- Population
- Patients undergoing elective craniotomy for brain tumors, West China Hospital, Sichuan University, 2018–2024528 (6.3%) developed seizures
- Participants
- 8,332 patients
- Exposure
- Intraoperative hypotension vs no hypotension
- Mean arterial pressure (MAP)<65 mmHgn = 6,563
- Outcome
- Postoperative seizures
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Adjusted odds ratio (95% CI)P value
MAP<65 mmHg vs MAP≥65 mmHg
1.29(1.01–1.70)
P = 0.04Each 1-SD decrease in MAP (12 mmHg)MAP as continuous variable
1.09(1.02–1.14)
P = 0.02Observational data: associations, not effects.
Further findings
Postoperative seizures, Youden index-derived cutoff 64 mmHg (sensitivity analysis)
- Consistent association of hypotension below the Youden index-derived cutoff (64 mmHg) with seizures: aOR 1.34 (95% CI 1.05-1.72), P = .02
- Sensitivity analysis
Postoperative seizures per 1-SD decrease in MAP (12 mmHg)
- Each 1-SD decrease in MAP (12 mmHg) associated with increased seizure risk: aOR 1.09 (95% CI 1.02-1.14), P = .02
- MAP as continuous variable
Postoperative seizures by nadir MAP category (<50, 50-55, 55-60, 60-65, 65-70, ≥70 mmHg)
- Dose-response: progressively higher seizure risk at lower MAP levels
- P for trend < 0.001
Postoperative seizures by cumulative duration of MAP <65 mmHg
- Longer durations of MAP <65 mmHg associated with increased seizure risk
- P for trend < 0.001
Original publication
Associations between intraoperative hypotension and postoperative seizures following craniotomy for brain tumor resection. J Clin Anesth. Published 8 April 2026. doi:10.
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