Perioperative medicine & outcomes
Intraoperative Hypotension in Patients Having Major Noncardiac Surgery Under General Anesthesia: A Systematic Review of Blood Pressure Optimization Strategies
Authors' conclusion
Several different blood pressure optimization interventions show promise in reducing exposure to intraoperative hypotension. Nonetheless, the impact of these interventions on clinical outcomes remains unclear.
Study context
- Population
- Patients having major noncardiac surgery under GA
- Participants
- 46,377 patients · 48 studies
- Comparison
- BP optimization interventions vs control
- Outcome
- Exposure to intraoperative hypotension and/or postoperative complications
Methodological detailsno meta-analysis (heterogeneity), 10 classes of BP optimization interventions; searched to August 2, 2023
- No meta-analysis (heterogeneity)
- 10 classes of BP optimization interventions; searched to August 2, 2023
Pooled result
As reported in the abstract
Intraoperative hypotension exposure
- Hemodynamic protocols using arterial waveform analysis, preoperative withholding of antihypertensives, continuous BP monitoring and adjuvant agents (vasopressors, anticholinergics, anticonvulsants) reduced intraoperative exposure to hypotension
- Low BP alarms had an inconsistent impact on exposure to hypotension
Further pooled results
- Limited evidence that higher prespecified intraoperative BP targets reduced risk of complications; few data that interventions prevented postoperative complications
Original publication
Intraoperative Hypotension in Patients Having Major Noncardiac Surgery Under General Anesthesia: A Systematic Review of Blood Pressure Optimization Strategies. Anesth Analg. Published 13 June 2025. doi:10.
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