Arterial stiffness as a risk factor for hypotension during induction of general anesthesia

Abstract

IntroductionHypotension after induction of general anaesthesia is identified as an independent factor in predicting adverse clinical outcomes. Preoperative evaluation of arterial stiffness could identify patients with an impaired vascular function and an altered haemodynamic response to induction of general anaesthesia. The purpose of this study is to investigate the relationship between arterial stiffness and blood pressure variation during induction of general anaesthesia.Material and methodsThis was an observational study that included patients who underwent surgical procedures under general anaesthesia. We used several systolic arterial pressure and mean arterial pressure thresholds for defining hypotension. Both absolute thresholds and thresholds relative to a baseline blood pressure were chosen based on the most frequently used definitions. Patient carotid-femoral pulse wave velocity determination, preoperative preparation, and induction of general anaesthesia were standardized.ResultsOur study included 115 patients. Both univariate and multivariate analysis showed that carotid-femoral pulse wave velocity was significantly associated with post-induction hypotension when defined as a systolic arterial pressure decrease of > 30% or > 40% from baseline or as a mean arterial pressure decrease of > 40% from baseline. Also, carotid-femoral pulse wave velocity was positively associated with duration of post-induction hypotension.ConclusionsPreoperative assessment of arterial stiffness identifies patients at risk of a pronounced decrease in blood pressure during induction of general anaesthesia.