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  3. 23.Is Pre-Operative Acute Rise in Blood Pressure before Eye and ENT Surgery A Genuine Excuse for Postponement of the Procedures?
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23.Is Pre-Operative Acute Rise in Blood Pressure before Eye and ENT Surgery A Genuine Excuse for Postponement of the Procedures?

Mohammad Mohsin Rana1, Sajid Rashid Nagra2, Zafar Latif Awan3, Danish Gani4, Zafar Iqbal Zafar4 and Khawaja Ishfaq Ahmed1

ABSTRACT

Objective: This study was carried out to alleviate the unnecessary taboos attached to it by studying the incidence and outcome of this unexpected finding.

Study Design: Observational cross section study

Place and Duration of Study: This study was conducted at the Rai Medical College Teaching Hospital (RMCTH), Sargodha from Jan –June, 2022.

Materials and Methods: All subjects between 20-90 years of age of both sexes, presenting for pre-operative assessment before any planned Eye and ENT surgery were assessed by measuring their BP. If it was found to be above 140/90 mmHg, they were included in this study. Consenting patients were referred to the physician for proper assessment and management prior to surgery.

Results: During the study period 288 surgeries were planned by Eye (67%, n192) and ENT (33%, n96) department. 25% (n72) were found to have their BP above 140/90 mmHg. Only these patients were referred to physicians for review and management and enrolled in the study. 42% were known hypertensives. Out of these 38% missed the morning dose of their antihypertensive medicine. The other 58%, both known hypertensives and previously normotensive had clear cut evidence of anxiety manifesting as palpitation, tremors and cold sweaty palms.

Conclusion: The available literature doesn’t support the common notion that pre-existing hypertension or pre-operative hypertension are associated with peri-operative hemodynamic instability or a poor surgical outcome. One must appreciate the difference between the increased chances of having complications in hypertension but the actual degree of being above the normal BP have no association with increased risk of complications. It can be concluded from this study It is perfectly safe to proceed with surgery till pre-operative BP is below 180/110 mmHg. Any such decision must be weighed against urgency and potential risk for postponement on individual basis with special emphasis in diabetics, CHD and renal disease.

Key Words: Hypertension, Pre-operative Hypertension, Eye and ENT surgery

Citation of article: Rana MM, Nagra SR, Awan ZL, Gani D, Zafar ZI, Ahmed KI. Is Pre-Operative Acute Rise in Blood Pressure before Eye and ENT Surgery A Genuine Excuse for Postponement of the Procedures? Med Forum 2022;33(11):93-97.