Assessing the safe resumption of antihypertensive medications following total hip or knee arthroplasty surgery.

Purpose: This exploratory, retrospective study aimed at examining whether patients experience orthostatic hypotension unnecessarily when antihypertensive medication(s) is simultaneously resumed following total joint replacement surgery.

Sample: The study sample consisted of 285 patients who underwent either total knee or total hip surgery and had a dual medical diagnosis of hypertension requiring treatment with more than 1 type of antihypertensive medication.

Method: Medical record reviews of all patients admitted to the orthopaedic unit from March 1, 2006, through June 30, 2006, at University of Pittsburgh Medical Center were analyzed to determine whether patients experienced any hypotensive event within 48 hr of their total joint replacement surgery following the resumption of their antihypertensive medications.

Results: Thirty-five percent of the patients experienced a hypotensive event following the resumption of their antihypertensive medications within the identified time frame. Among patients who had documented evidence of a hypotensive episode prior to the resumption of their antihypertensive medication, 42% of those experienced hypotension after postoperative medication administration versus 28% in patients without prior hypotensive episodes (p = .50).

Conclusions: These findings indicated the need for clear nursing guidelines outlining time frames for the assessment and documentation of blood pressure reading prior to antihypertensive medication administration.