467 PERIOPERATIVE BLOOD PRESSURE CHANGES IN THE PATIENTS WITH CATARACT SURGERY

Abstract

Objectives: To investigate perioperative blood pressure(BP) changes in the outpatients with cataract surgery. Design and Methods: Forty-one outpatients (mean age 71.2 ± 7.2 years) who visited an ophthalmologic clinic for cataract surgery were enrolled. Sitting BP was measured at the clinic visit before surgery(Clinic BP). On the day of surgery, BP was measured 1 hour before surgery (Pre BP).During the surgery, BP was measured every 5 minutes. Clinic BP and Pre BP were averaged and defined as baseline BP. First 3 BP measurements during surgery were averaged and defined as operative BP.Max BP was the maximum BP values during surgery.Characteristics, pharmacological records and blood chemistry of the patientswere collected.The predictive ability of baseline BP for excessive operative BP elevation was evaluated using receiver-operated characteristic analysis. Results: Twenty-eight patients(63.6 %) were treated with antihypertensive drugs(HT group).The average changes frombaseline to operative BP were +13.9 ± 13.9/8.4 ± 8.7 mmHg(baseline BP:134.7 ± 13.9/74.4 ± 10.6 vs operative BP: 148.6 ± 22.6/82.9 ± 10.9, P < 0.05).Max BP was 152.8 ± 23.4/83.5 ± 11.5 mmHg.In 8 patients(18.2 %), systolic BP(SBP) reached 170mmHg(excessive riser). Operative and Max SBP were significantly correlated with baseline SBP (operative BP: r = 0.67, P < 0.01, Max BP: r = 0.70, P < 0.01) but not with age. The magnitude of the changes of SBP was not associated with baseline SBP. Max SBP in HT were significantly higher than non-HT (159.0 ± 18.0 vs143.3 ± 3.3, P < 0.01).In the subgroup of excessive riser, baseline SBP and increment SBP were significantly greater (151.1 ± 13.0 vs130.7 ± 14.9, P < 0.01 and +24.2 ± 19.0 vs +11.4 ± 15.1, P < 0.05, respectively). Multiple regression analyses indicated that Max SBP was significantly associated with baseline SBP (ß 1.05, P < 0.01). Pre SBP predicted excessive riser more accurately than Clinic SBP and the cut off values of that at maximum sensitivity (75.0 %) and specificity (78.8 %) was 144 mmHg. Conclusions: Baseline SBP can predict excessive SBP elevation during surgery. Patients whose preoperative SBP are more than 145 mmHg needscareful monitoring of BP during surgery and appropriate medication may be considered to prevent perioperative cardiovascular event.