Background: Postoperative stroke is a rare but major complication after surgery. The most often proposed mechanism is an embolus originating from the heart or great vessels. The role of intraoperative hypotension in the occurrence and evolution of postoperative stroke is largely unknown.
Methods: A case-control study was conducted among 48,241 patients who underwent noncardiac and nonneurosurgical procedures in the period from January 2002 to June 2009. A total of 42 stroke cases (0.09%) were matched on age and type of surgery to 252 control patients. Conditional logistic regression analysis was used to estimate the effect of the duration of intraoperative hypotension (defined according to a range of blood pressure thresholds) on the occurrence of an ischemic stroke within 10 days after surgery, adjusted for potential confounding factors.
Results: After correction for potential confounders and multiple testing, the duration that the mean blood pressure was decreased more than 30% from baseline remained statistically significantly associated with the occurrence of a postoperative stroke.
Conclusions: Intraoperative hypotension might play a role in the development of postoperative ischemic stroke. Especially for mean blood pressure values decreasing more than 30% from baseline blood pressure, an association with postoperative ischemic stroke risks was observed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/ALN.0b013e3182472320 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Rare Case of Necrotizing Fasciitis Presenting As Tarsal Tunnel Syndrome in a Patient With Uncontrolled Diabetes.
Cureus
December 2024
Trauma and Orthopedics, Lister Hospital, Stevenage, United Kingdom.
Necrotizing fasciitis is a severe and rapidly progressing soft tissue infection that requires immediate intervention. However, its manifestation as tarsal tunnel syndrome in a diabetic patient is an extremely rare occurrence, with no previous reports found in the existing literature. We present a case report of a patient in their late 50s with uncontrolled diabetes who had necrotizing fasciitis and presented initially to the emergency department with hypotension.
View Article and Find Full Text PDFEffects of Neuraxial or General Anesthesia on the Incidence of Postoperative Pulmonary Complications in Patients Undergoing Peripheral Vascular Surgery: A Randomized Controlled Trial.
J Cardiothorac Vasc Anesth
December 2024
Programa de Pós-graduação em Ciências Pneumológicas, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Objectives: Postoperative complications after major surgery, especially in vascular procedures, are associated with a significant increase in costs and mortality. Postoperative pulmonary complications (PPCs) have a notable impact on morbidity and mortality. The primary aim of this present study was to evaluate the effects of spinal anesthesia compared with general anesthesia on the incidence of PPCs in patients undergoing lower extremity bypass surgery.
View Article and Find Full Text PDFRemimazolam Versus Propofol in General Anesthesia of Complex Surgery in Critical and Non-Critical Patients: Meta-Analysis of Randomized Trials.
J Clin Med
December 2024
Escuela de Medicina, Universidad Señor de Sipán, Chiclayo 14001, PC, Peru.
: To compare the efficacy and safety of remimazolam with propofol in general anesthesia in adult patients. : A systematic search in Pubmed, Scopus, Web of Science, and Embase was performed. Patients undergoing complex surgery who were critically ill or non-critically ill were included.
View Article and Find Full Text PDFCesarean delivery: Clinical updates.
Best Pract Res Clin Anaesthesiol
September 2024
K. Bicetre School of Medicine, Paris-Saclay University, Département d'Anesthésie, Hôpital Antoine Béclère - APHP.Université Paris-Saclay, 157 rue de la porte de Trivaux, 92140, CLAMART, France. Electronic address:
This article offers a comprehensive clinical update on best practices for neuraxial and general anesthesia in cesarean delivery, the most frequently performed major surgical procedure globally. Current evidence-based strategies to address common anesthetic challenges, such as maternal hypotension and intraoperative breakthrough pain, are discussed in detail. Practical approaches for optimizing maternal hemodynamic stability, including the use of vasopressors, fluid management and maternal positioning, are reviewed.
View Article and Find Full Text PDFHypermagnesemia- and Hyperphosphatemia-Associated Cardiac Arrest after Injection of a Novel Magnesium-Based Bone Cement in Spinal Surgery.
J Am Acad Orthop Surg Glob Res Rev
January 2025
From the Department of Orthopaedic Surgery, Singapore General Hospital, Singapore (Dr. Loh, Dr. Ling, Dr. Jiang, and Lim) and the Department of Surgical Intensive Care, Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore (Dr. Goh).
We report a case of pulseless electrical activity (PEA) associated with profound hypermagnesemia immediately after cementation of a novel magnesium-based cement in spine surgery. During T8 to T12 posterior instrumentation and decompression laminectomy for vertebral metastasis secondary to lung cancer, a 61-year-old Chinese woman developed sudden hypotension and went into PEA immediately after injection of a novel magnesium-based cement. Intraoperative fluoroscopic imaging did not show any notable cement extravasation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!