The influence of anesthetic drug strategy on the incidence of post-induction hypotension in elective, non-cardiac surgery – A prospective observational cohort study
Authors' conclusion
PIH was common in this patient cohort, regardless of the definition used. Two of the five examined modifiable factors were associated with PIH: remifentanil infusion was associated with an increased risk, and pre-emptive vasopressor use was associated with a decreased risk of PIH.
Study context
- Population
- Adult ASA I–IV patients undergoing elective non-cardiac surgery under general anesthesia (GA)720 analysed
- Participants
- 760 patients
- Exposure
- Modifiable induction factors and post-induction hypotension (PIH)
- Outcome
- Incidence of PIH and associated modifiable factors
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- PIH, mean arterial pressure (MAP) <65 mmHg threshold
- 238 (33.1 %)
- PIH, 30 % MAP decrease threshold
- 287 (39.9 %)
- Remifentanil and PIH (MAP <65 mmHg): OR 1.88, 95 %CI 1.31-2.69
- p < 0.001
- Remifentanil and PIH (30 % MAP decrease): OR 1.66, 95 %CI 1.15-2.40
- p = 0.007
- Pre-emptive vasopressor (before or during first min of GA) and PIH (MAP <65 mmHg): OR 0.65, 95 %CI 0.45-0.95
- p = 0.027
- Pre-emptive vasopressor and PIH (30 % MAP decrease): OR 0.58, 95 %CI 0.40-0.84
- p = 0.004
Observational data: associations, not effects.
Further findings
Propofol bolus dose by patient factors
- Propofol bolus dose decreased with increasing age and ASA physical status
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The influence of anesthetic drug strategy on the incidence of post-induction hypotension in elective, non-cardiac surgery – A prospective observational cohort study. J Clin Anesth. Published 28 October 2024. doi:10.
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