Is intraoperative remifentanil infusion associated with early postoperative hypertension in intracranial tumor surgery?

Abstract

Hemodynamic instability may cause serious complications such as intracranial hemorrhage, stroke, and brain edema in the postoperative period in intracranial tumor surgery. This study investigated the relationship between remifentanil infusion used for anesthesia maintenance in intracranial tumor surgery and postoperative early hypertension. Hemodynamic parameters were recorded in the first 24 hours after intracranial tumor surgery in the postoperative intensive care unit. Hypertension rate, causes, and treatment methods of hypertension in our clinic were compared with the literature. The study included 113 patients. In 83 patients (73.4%), hypertension was detected in the first 24-hour period during the intensive care follow-up. The hypertensive attack was controlled with intravenous opioids administered in 69 (83.1%) of 83 patients with hypertension, and with additional intravenous antihypertensive in 14 (16.9%) patients. Analgesia use was higher in hypertensive patients in the first 24 hours postoperatively (83.1% vs. 30%, P<.01). Ultra-short-acting remifentanil infusion used for maintenance of anesthesia may cause hypertensive episodes in the early postoperative period.