Perioperative hypertensive crisis. The anaesthetic implications. A Review of Literature

摘要

Hypertensive emergencies involve a series of clinical presentations where uncontrolled blood pressure (BP) leads to progressive end-organ dysfunction affecting the neurological, cardiovascular, renal, or other organ systems. In these situations, the BP should be controlled over minutes to hours. Many causes are involved in severe elevation of blood pressure; inadequate treatment of hypertension, renal diseases, head trauma and pre-eclampsia. Intraoperative hypertension is also common and has many causes. It is usually successfully controlled by anaesthetists. However, there is a lack of agreement concerning treatment plans and appropriate therapeutic goals, making common management protocols difficult. A wide range of pharmacological alternatives are available to control blood pressure and reduce the risk of complications in these patients. This article reviews the perioperative hypertensive crisis and the common strategies used in management.Perioperative hypertension commonly occurs in patients undergoing surgery. Accurate adjustment of treatment and monitoring of patient’s response to therapy are essential to safe and effective management of perioperative hypertension.