High blood pressure after general anesthesia. Complications after anesthesia. Complications from the cardiovascular system

Arterial hypertension occurs in 25% of patients undergoing surgery. A marked increase in blood pressure is fraught with the development of ischemia or myocardial infarction, arrhythmia, heart failure, pulmonary edema, increased intraoperative blood loss, rupture of vascular sutures, increased intracranial pressure, hypertensive encephalopathy or intracerebral hemorrhage.

When collecting anamnesis, the severity and duration of arterial hypertension are revealed. It is believed that hypertension of the first and second stages does not increase the risk of complications in the perioperative period (systolic blood pressure does not exceed 180 mm Hg, and diastolic blood pressure is below 110 mm Hg). The presence and severity of pathological changes that accompany hypertension and increase the risk of complications are clarified: kidney pathology, the presence of coronary artery disease, heart failure, myocardial infarction, a history of cerebrovascular accidents, damage to the organs of vision. Pay attention to pathology of the kidneys, adrenal glands, thyroid gland, excluding the secondary nature of hypertension. It is necessary to find out what antihypertensive drugs the patient is using. Central β-agonists (clonidine), β-blockers can cause rebound symptoms when they are discontinued. In addition, central adrenergic agonists have a sedative effect and reduce the need for anesthetics. Diuretics, often prescribed to such patients, contribute to the development of electrolyte disturbances, in particular hypokalemia, and potassium-sparing diuretics (spironolactone, triamterene) - hyperkalemia. These drugs obviously reduce the volume of circulating blood, which, without adequate infusion therapy, can cause severe hypotension, especially during induction of anesthesia. There is evidence that angiotensin-predominant enzyme blockers, in particular captopril, sometimes cause difficult-to-correct hypotension and hyperkalemia. The use of β-blockers contributes to the occurrence of bradycardia, AV block, decreased myocardial tone, increased bronchial tone, and depression.

Bradycardia, myocardial depression when using β-blockers during anesthesia is usually well corrected with atropine, calcium chloride, in rare cases there is a need to use adrenergic agonists

Undesirable consequences of taking calcium channel blockers (verapamil, diltiazem) include a decrease in myocardial contractility, bradycardia, conduction disturbances, and potentiation of the action of non-depolarizing muscle relaxants.

During a physical examination, the boundaries of the heart are determined in order to clarify the severity of ventricular hypertrophy. During auscultation, a presystolic gallop rhythm is often heard, associated with severe left ventricular hypertrophy. With the development of heart failure, wheezing in the lungs and a proto-diastolic gallop rhythm are detected. Pay attention to the presence of peripheral edema (manifestation of cardiac or renal failure); signs of hypovolemia are possible: dry skin and tongue. Blood pressure measurements are carried out, if possible, in a lying or standing position.

If organ changes are not pronounced (hypertension stages I, II), generally accepted laboratory and instrumental studies are performed. Pay attention to the level of blood electrolytes, creatinine, the presence of proteinuria, electrocardiographic changes, and a chest x-ray (to determine the degree of left ventricular hypertrophy).

If there are functional changes in internal organs, their severity should be clarified. To do this, studies of the functional state of the cardiovascular system are carried out: ECG with stress tests, IRGT with exercise tolerance test, Echo-CG, which often reveals changes that are invisible during ECG and X-ray studies. If, during a preliminary examination, there is a suspicion of renal failure, an in-depth examination of renal function is carried out, including determination of the glomerular filtration rate, ultrasound of the kidneys, etc. In patients with previously undiagnosed hypertension, the duration and severity of the process can be judged by the degree of changes in the fundus. The Keith-Wagner classification is most often used, dividing patients into 4 groups: 1) constriction of retinal arterioles. 2) constriction and sclerosis of retinal arterioles. 3) hemorrhages and exudate in addition to the first two signs. 4) swelling of the optic nerve nipple (malignant hypertension).

Relative contraindications to elective surgery are diastolic pressure above 110 mmHg. Art. especially in combination with target organ damage (heart, kidneys, central nervous system). In such cases, drug correction of hypertension should be carried out.

In the preoperative period, patients usually continue taking antihypertensive drugs according to the usual regimen. In order to reduce feelings of anxiety, fear and, consequently, hemodynamic changes, sedatives are prescribed immediately before surgery. Premedication most often includes benzodiazepines; according to indications, neuroleptics and central β-agonists are used. In patients with arterial hypertension, ganglion blockers (arfonad, pentamine) are widely used. The following technique can be used: before surgery, the patient’s blood pressure response to intravenous administration of hexonium or pentamine at a dose of 0.2 mg/kg is determined. If there is no change in blood pressure, then the same dose is administered during the onset of anesthesia and surgery; in the presence of a hypotensive reaction, the dose of the drug is halved. Then the same dose is repeated and, finally, the “remainder” of the adapting dose is administered - 0.35 mg/kg. Injections are made after 5 – 7 minutes. To consolidate tachyphylaxis and enhance ganglioplegia, the gangliolytic is administered once again at a dose of 0.75 - 1 mg/kg. If necessary, during the operation the drug can be re-administered at a dose of 1 – 3 mg/kg. In this way, reliable ganglion blockade is achieved while maintaining blood pressure at a normal level.

In emergency anesthesiology, there are situations when a patient develops a hypertensive crisis against the background of acute surgical pathology. In this case, before the operation begins, it is necessary to try to reduce blood pressure to a working level. If hypertension is caused by a stressful situation, it is possible to use benzodiazepines (sibazone 5-10 mg), antipsychotics (fractional administration of droperidol 2.5-5 mg every 5-10 minutes). If it is necessary to achieve a quick effect (hypertensive crisis with the development of an attack of angina, heart failure), nitrates are used, starting from 25 mcg/min until the desired blood pressure level is achieved. It should be remembered that most often patients with emergency surgical pathology have a state of hypovolemia, against the background of which a sharp decrease in blood pressure is possible, therefore antihypertensive therapy should be combined with the elimination of hypovolemia.

All known methods and drugs can be used to provide anesthesia in patients with hypertension (with the exception of ketamine). Switching off consciousness during induction of anesthesia is carried out with barbiturates. In addition, anesthesia with the use of diprivan and clonidine (150 mcg 15 minutes before surgery) has worked well. It is possible to use neuroleptanalgesia. During emergency surgery, ataralgesia is often used. In any case, given the hemodynamic instability in patients with arterial hypertension, adequate infusion therapy is required during the perioperative period with a combination of crystalloid and colloid drugs. It is necessary to ensure a sufficiently deep level of anesthesia before performing traumatic manipulations (intubation, catheterization of the bladder, skin incision, etc.). During anesthesia, it is advisable to maintain blood pressure at the level of working values, however, a decrease in blood pressure by 20-25% from the initial value usually does not cause disturbances in cerebral blood flow and renal filtration.

Kidney function is monitored using hourly diuresis. If hypertension occurs during anesthesia, it is necessary to find its cause (insufficient analgesia, hypoxia, etc.) and take appropriate action. If there is no result, it is necessary to use antihypertensive drugs - sodium nitroprusside, nitroglycerin, phentolamine, ganglion blockers, β-blockers (the negative inotropic effect of inhalational anesthetics may be enhanced).

In the postoperative period, careful monitoring of blood pressure and, if possible, early extubation are also necessary. If prolonged ventilation is necessary, sedatives are used. As the patient's functional state recovers after surgery, one should strive to prescribe the patient's usual treatment regimen earlier. If hypertension is detected for the first time, treatment should be prescribed taking into account the stage of hypertension.

Problems with it lead to a decrease in oxygen supply and, as a result, problems with the heart and brain.

Why do blood pressure spikes occur?

Shock is the reason low pressure or high during or after heart surgery. It has several varieties:

Hemorrhagic - it is caused by a sudden loss of blood. Its symptoms include a drop in blood pressure and pale skin.
Obstructive is a condition in which oxygen does not reach the organs because blood circulation is impaired by some physical obstacle.
Cardiogenic is a disorder of the heart associated with improper muscle contraction.
Septic - it is caused by blood poisoning, which makes it unusable. Accompanied by low blood pressure without bleeding.

Blood pressure problems can be caused by allergies or dehydration. In the first days after surgery, there is a possibility of heavy blood loss. That is why the medical staff carefully monitors postoperative patients. Constantly check the pulse rate, measure blood pressure and monitor the patient's condition.

Hypotension indicates bleeding during or after surgery, while hypertension can lead to a hypertensive crisis and requires emergency care.

What are the risks of high and low blood pressure after surgery?

After surgery, high blood pressure should normalize during the healing process. But it leads to extra work heart and blood vessels, which can lead to stroke or heart attack. The organs will not receive enough oxygen, as a result of which they will do their job poorly, and the body will work for wear and tear.

If the patient has low blood pressure, kidney failure occurs, the patient loses consciousness (which can be traumatic) or falls into a coma. It is also dangerous because it causes disruption of the brain, because the required amount of oxygen does not reach the brain with the blood. It affects a person's hearing, vision and memory. Hypotension is a sign of serious disorders in the body and serious diseases. If you feel nausea, dizziness and loss of coordination of movements, consult a doctor immediately.

How to lower blood pressure?

If hypotension occurs after surgery, you should immediately consult a doctor. He will advise you to change your diet and lifestyle. In order to stick to your diet correctly, follow a few simple rules:

Be sure to reduce or completely eliminate salt from your diet. The daily norm should not exceed two grams of salt. You can replace it with seasonings (paprika, marjoram or parsley).
Take fruits or vegetables for a snack.
Eat more complex carbohydrates.
Try to eat small meals 6-8 times a day.
Reduce fat intake. Which can be replaced with dairy products and lean poultry.
Limit your sugar intake.

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Lifestyle

News healthy image life must begin by renouncing bad habits(smoking and alcohol). Smoking leads to vasoconstriction and hypertension. If a patient is taking recovery medications after surgery, he should be aware that alcohol interacts with many medications and is generally contraindicated. Also try not to be nervous or you can do various relaxation exercises. Play sports, but only after your doctor's permission.

Taking medications

The doctor may prescribe medications to normalize blood pressure. If the patient has previously taken any medications for an illness, he must inform the doctor about this, since medications have the ability to interact with each other. Many medications help keep blood vessels toned. List of possible medications:

How to increase blood pressure?

Hypotension after surgery is common and generally resolves quickly and without medical attention, but requires attention and monitoring.

The patient should move slowly without sudden movements. It is worth giving up alcohol and caffeine - they can lead to dehydration and lower blood pressure even more. If hypertension excludes salt, then in case of hypotension, on the contrary, consume as much salt as possible. The doctor may prescribe medications (Niketamide, also known as Cordiamin, Bellataminal, Fludrocortisone and Deoxycorticosterone), which must be taken strictly as prescribed and the dosage observed.

High blood pressure after anesthesia: what is the cause and how to treat?

A healthy person after anesthesia experiences a decrease in blood pressure and short-term bradycardia. This is due to the peculiarity of the effect of anesthesia drugs on the body. Increased blood pressure after anesthesia can be observed in hypertensive patients due to decreased vascular elasticity. In most cases, this is a short-term phenomenon, but if there is a significant increase in blood pressure, appropriate measures must be taken.

Why does blood pressure change after anesthesia?

Normally, blood pressure is always low after general anesthesia. This is due to the principle of action of drugs used for pain relief. They inhibit the activity of the nervous system, as a result, all processes in the body slow down. Since the nervous system needs time to recover, on the first day after general anesthesia, loss of strength and dizziness may occur due to a decrease in pressure (nmmHg). compared to normal levels for humans.

High blood pressure after anesthesia is a problem for hypertensive patients. This is explained by the following mechanisms occurring in the body.

Long-term hypertension leads to impaired elasticity of blood vessels. They lose flexibility and can no longer quickly respond to changing internal and external conditions. Due to loss of elasticity, changes in vascular tone occur slowly and are usually always elevated, which is explained by the peculiarities of the cardiovascular system.

In hypertensive patients, vascular elasticity is insufficient for an adequate response

When anesthesia is administered, all processes in the body slow down. The absence of pain is explained by the effect on the nervous system, which inhibits the functioning of certain receptors. At this time, for every person, including hypertensive patients, all processes occurring in the body, including blood pressure, heartbeat and breathing, slow down.

After the anesthesia ceases to act, vascular tone rapidly increases, that is, it returns to the normal state characteristic of hypertension. Due to the prolonged decrease in vascular tone during the action of anesthesia, too rigid walls experience even greater stress, so the pressure increases. For example, if before the operation a hypertensive patient always had a blood pressure of 150 mmHg, after the anesthesia wears off it can jump to 170. This condition persists for some time, and then the pressure returns to normal.

What is the danger of increased blood pressure during surgery?

In rare cases of hypertension, blood pressure remains high even despite the effect of anesthesia. This phenomenon is dangerous and requires monitoring the patient's condition during the operation.

There are a number of risks when administering strong anesthesia to hypertensive patients. These include:

cerebral hemorrhages during surgery;
disturbance of heart rhythm in response to anesthesia;
heart failure;
hypertensive crisis after cessation of anesthesia.

Adequate treatment of hypertension before surgery helps prevent dangerous complications. Usually the operating doctor, knowing about the patient’s high blood pressure, gives a number of recommendations some time before the operation. This allows you to minimize negative consequences anesthesia.

High blood pressure during surgery can cause bleeding

Hypotension and anesthesia

If with hypertension the danger is that the pressure remains high both during anesthesia and after surgery, then with hypotension the risks are due to a sudden drop in blood pressure.

After anesthesia, low blood pressure drops even lower, especially when general anesthesia is administered. During surgery, patients' vital signs are carefully monitored, as there is a risk of blood pressure dropping to critical values.

During the operation, negative reactions of the body to the effects of anesthesia may occur. For hypotensive patients, this is dangerous due to acute cerebral hypoxia and sudden cardiac arrest.

Help for hypertensive patients after anesthesia

Having realized that pressure can actually increase after anesthesia, you should first consult with an anesthesiologist and operating doctor about methods of reducing pressure after the anesthesia wears off.

Typically, hypertensive patients are given an injection of magnesium to reduce blood pressure in the hospital. The clinic staff carefully monitors fluctuations in the patient’s blood pressure both during the operation and after the anesthesia wears off.

If magnesium is ineffective, more potent drugs can be used. In addition to medications, a patient prone to high blood pressure is prescribed bed rest, regardless of the type of operation, and rest. To speed up recovery after anesthesia, a balanced diet is necessary.

Before surgery, hypertensive patients must inform the doctor about all allergic reactions to drugs. It is imperative to inform the doctor about the antihypertensive medications that the patient takes constantly.

Despite the discomfort caused by a rise in pressure, the patient has nothing to worry about, since the normalization of blood pressure after the operation is carried out by qualified specialists.

In Russia, there are from 5 to 10 million calls to the ambulance every year medical care regarding increased blood pressure. But Russian heart surgeon Irina Chazova claims that 67% of hypertensive patients do not even suspect that they are sick!

How can you protect yourself and overcome the disease? One of the many recovered patients, Oleg Tabakov, told in his interview how to forget about hypertension forever.

High blood pressure – treatment is required - Why it’s dangerous

Why is high blood pressure dangerous?

First of all, high blood pressure is dangerous due to a sudden sharp rise in blood pressure - a hypertensive crisis, which can lead to stroke, myocardial infarction, severe kidney complications, and so on. As a result, a person may remain disabled for life.

But the danger exists even without crises, when high blood pressure does not manifest itself in any way for a long time. Since the blood vessels are in a constant state of spasm, organs and tissues do not receive enough nutrients and oxygen. The brain, heart and kidneys are especially affected by this. In all organs and tissues, against this background, sclerotic phenomena develop - instead of the tissue of one or another organ, connective tissue grows, which leads to dysfunction of the organ.

That is why, with untreated hypertension, a person’s memory and coordination of movements are impaired, trembling of the limbs, shortness of breath, urination problems, significant impairment of kidney function, and so on. Diseases caused by high blood pressure are associated with dysfunction of internal organs - the brain, heart, kidneys, vision organs, and so on. The consequences of high blood pressure can be very serious, which is why it should be identified and treated as early as possible.

Symptomatic arterial hypertension

High blood pressure can also be a consequence of diseases of a specific organ. High blood pressure is very common in kidney disease. Most often, symptomatic arterial hypertension develops in diseases such as glomerulonephritis (infectious-allergic kidney disease) and congenital vasoconstriction of the kidneys. Pyelonephritis and high blood pressure are not such a characteristic phenomenon, however, a long-term inflammatory process can also lead to a narrowing of the blood vessels of the kidneys. As a result of the narrowing of the arteries, the kidneys begin to produce the hormone renin, which contributes to a sharp narrowing of all blood vessels and a persistent rise in blood pressure, while the lower (diastolic) pressure increases to a greater extent. High blood pressure and kidneys are a very common combination, so during the initial examination of a patient with high blood pressure, kidney disease is first ruled out.

High blood pressure can also occur with certain diseases of the adrenal glands (for example, with an adrenal tumor, pheochromacytoma). The tumor in this case produces adrenaline, which contributes to a persistent increase in blood pressure.

High blood pressure in diabetes is no less common. This is facilitated by atherosclerosis Atherosclerosis - when there are problems with blood vessels, obesity, as well as increased blood viscosity, characteristic of diabetes. Therefore, all diabetics are advised to monitor not only their blood sugar, but also their blood pressure.

High blood pressure is also very typical during menopause - blood pressure increases due to hormonal disorders. Hormonal disorders: causes and most common diseases. At the same time, blood pressure rarely rises steadily - menopause is more characterized by significant changes in blood pressure, which are difficult for women to tolerate. If a complex such as menopause and high blood pressure develops, the woman will need adequate treatment with antihypertensive drugs.

High blood pressure can be transient, for example after significant stress. An example would be high blood pressure after surgery, which returns to normal as the patient recovers. But it is dangerous because it can cause bleeding, so in the postoperative period anesthesiologists carefully monitor the patients’ blood pressure.

High blood pressure with a cold also occurs, but in this case you should definitely call a doctor, since the symptoms of a cold (for example, high temperature) can be confused with the symptoms of an incipient myocardial infarction - necrosis of heart muscle tissue can also be accompanied by fever.

There is high blood pressure after a stroke, high blood pressure after myocardial infarction - the doctor decides whether to reduce it or not, since a slight increase in blood pressure in this case can even be useful - it contributes to better growth of collaterals of blood vessels that feed the changed tissue areas.

High blood pressure in liver diseases Liver diseases: when the natural filter malfunctions, it does not develop in the entire circulatory system, but only in the portal vein and is called portal hypertension. Portal hypertension is usually caused by cirrhosis of the liver or a congenital abnormality of the liver vessels. The effect of liver diseases on pressure in the portal vein system is characterized by the fact that blood from the liver enters the heart not only directly, but also in a roundabout way, through other organs of the gastrointestinal tract. This leads to dilation of the veins in this area and frequent bleeding. Stagnation of blood in the liver area causes ascites (sweating of liquid part of the blood into the abdominal cavity), which is often accompanied by dilation of the veins around the navel (capita jellyfish).

High intraocular pressure

High eye pressure develops when the outflow of intraocular fluid from the eye is impaired. The outflow of fluid is disrupted either due to blockage of access to the outflow tract, or due to changes in the outflow system itself. This leads to an increase in pressure in the eyeball, it begins to compress the optic nerve, which gradually leads to the development of metabolic-dystrophic processes in it, and then (with a long course of the disease) to complete atrophy. In this case, vision initially simply decreases due to a narrowing of the visual fields, and then (with atrophy) complete blindness occurs. High intraocular pressure can cause severe headaches and pain in the eye socket in patients.

Complicated rehabilitation period: causes and dangers of low blood pressure after surgery

One of the most important indicators of the general condition of the body is blood pressure. Its boundaries have long been specified; indicators of 120/80 are considered normal.

But this is not an ideal at all; doctors have another definition; for them, the pressure at which a person feels healthy is considered optimal.

And here the range of numbers is completely different – /60-90. All other indicators, no matter which way they go - down or up, are considered a deviation from the norm, characteristic feature hypertension or hypotension.

The difference between systolic pressure (first number) and diastolic pressure (second number) should ideally be unity. If this interval is more or less than specified, the person does not feel too good. During any surgical interventions, even the most minor ones, doctors always pay great attention to the patient’s blood pressure.

Often you even have to wait out an unfavorable period in the patient’s condition. When you have low (high) blood pressure and surgery cannot be avoided, you should take this extremely seriously. You will need to carefully follow all doctor's orders to eliminate signs of hypertension and hypotension.

What are the dangers of surgery for low blood pressure?

Everyone knows that hypertension is very life-threatening. But low blood pressure is also associated with a certain amount of risk, especially when it comes to surgical interventions. If the patient has hypotension during the operation and for some time after it, death is possible.

These fears are supported by statistical data. Thus, over 252 thousand patients who needed surgical operations were under the supervision of doctors for a long time.

The determining factors during the examination of the patient were:

health problems;
nationality;
taking medications;
objective risks during and after surgery;
patient pressure.

It turned out that patients with low systolic pressure (less than 100 mm H.S.) were 40% more likely to die on the operating table or immediately after surgery. The situation was even worse for those whose lower indicator was less than 40 mm.r.s. – their risk of death increased two and a half times.

The presented statistical data allowed us to conclude that the attention of surgeons preparing patients with low blood pressure for operations cannot be called sufficient. The number of deaths convincingly proves this. Now the question of whether it is possible to perform surgery for hypotension should be answered this way - with indicators close to critical (less than 100/below 40), this is extremely dangerous.

But a clear verdict has not yet been made.

Scientists have yet to find out whether taking medications that increase blood pressure will be an effective means for successful operations and a stable rehabilitation period.

Low blood pressure after surgery: some nuances

When hypotension is observed, the following processes can occur in the human body:

hearing loss;
vision problems;
memory impairment;
renal failure;
loss of consciousness;
falling into a coma.

Hypotonic people, without any equipment, only based on monitoring their own well-being, can accurately determine that their blood pressure has become even lower.

As a rule, hypotensive people feel:

And these three symptoms are a reason to immediately consult a doctor. Hypotension often appears after surgery, during the rehabilitation period.

If the patient is already at home, he needs to pay close attention to his lifestyle and diet. The rules are simple and clear, but they must be followed strictly and methodically.

So, we bring our own diet back to normal, for this it is enough:

maintain proper drinking regimen (8-12 glasses of water per day);
for snacks between meals, eat only vegetables or fruits;
eat small portions (6-8 times a day);
increase the amount of fatty foods;
consume more complex carbohydrates;
increase the amount of sugar.

Fish, caviar, eggs, fatty meats, and butter are healthy.

It remains to find out which foods contain complex carbohydrates; their list is very impressive; here are the most common and accessible ones:

Hypotension and bad habits of the patient

An unhealthy lifestyle also greatly affects the decrease in blood pressure after surgery.

If you have hypotension, it is recommended to exercise; this always leads to an improvement in your well-being, but a set of physical exercises should be prescribed to you by your attending physician.

You should not make sudden movements, turns, or tilt your head; fast walking and running are contraindicated; all this must be taken into account. Bad habits - drinking alcohol and smoking should be left in the past.

Do not forget that alcohol interacts chemically with many medications and can cause irreparable harm to the body. Alcohol, like caffeine, causes dehydration, which leads to a further decrease in blood pressure.

Stress is one of the main causes of blood pressure problems

Stress and excessive nervousness are also extremely undesirable phenomena with hypotension. Try to treat all negative incidents in your life with a certain amount of complacency and some detachment. This will keep the nervous system calm.

Proper rest and relaxation also helps bring low blood pressure back to normal. Sometimes patients want to sleep all the time. There is nothing wrong with this, which means you just need to increase your sleep period. In hypotensive patients it ranges from 10 to 12 hours and this is considered normal.

What are the reasons for hypotension during and after surgery?

Most patients who had normal blood pressure before surgery are extremely surprised that after surgery their usual levels decrease significantly.

Meanwhile, doctors are well aware of what causes this problem.

Most often, hypotension after surgery is temporary, and its occurrence depends on many reasons, which include hypovolemic, cardiogenic, septic shock, or a reaction to pain relief. Any operation, even the simplest and shortest, is a difficult test for our body.

When it comes to complex and urgent interventions, for example, with injuries, the patient experiences hypovolemic shock during major blood loss. His blood flows rapidly and in spurts from his veins. At the same time, the pressure drops, the pulse rate increases, and urine output is reduced. In cardiogenic shock, the heart loses its ability to pump blood effectively.

Most often, this condition is observed during heart attacks.

Septic shock is caused by an infection that affects the patient's body. As a result of its action, dilation of the arteries and a decrease in blood pressure are observed. All this is accompanied by fever and rapid heartbeat.

Anesthesia is also a severe stress for the body. A side effect of anesthesia, designed to alleviate the patient’s condition during surgery, is a decrease in blood pressure. It can begin right on the table, or later, during the rehabilitation period.

Video on the topic

About methods of treating hypotension in the video:

Monitoring blood pressure is one of the most important commandments of a doctor during surgery; after surgery, the patient must independently monitor the condition of his body, immediately informing the doctor about the appearance of unwanted symptoms.

How to beat HYPERTENSION at home?

To get rid of hypertension and cleanse blood vessels, you need.

High blood pressure after surgery

Good afternoon, is it normal for me to have high blood pressure after surgery?

Many people may complain of spikes in blood pressure as a result of surgery. For what reasons does this pathology occur? Increased blood pressure after surgery is observed after the administration of anesthesia. Because anesthetics contain large amounts of adrenaline. In order to normalize the condition after surgery, the attending physician prescribes a course of treatment with medications that reduce this indicator, namely:

1. Diuretics. They prevent fluid retention in the body. The most effective agents are: Hydrochlorothiazide, Cyclomethiazide, etc. You can also use traditional medicine recipes.

2. Beta-blockers. They have a positive effect on the functioning of the cardiovascular system. For this, the following drugs are used: Bisoprolol, Anaprilin, Metoprolol and others.

3. ACE inhibitors. Their action is aimed at reducing blood flow to the heart. The most common drugs in this group are: Capoten, Zocardis, Enalapril and others.

4. Sartans. Used when there is a sharp increase in blood pressure to alleviate the condition. They should be taken once. Examples of such drugs: Lozap, Losartan, Valsacor.

5. Calcium channel blockers. Increases the tolerance of stress on the heart. The following medications are used for this purpose: Amlodipine, Norvasc, Cordaflex.

A course of treatment with such drugs will help normalize blood pressure after surgery. After all, even local anesthesia can cause such disorders.

High blood pressure after surgery - is this normal?

Why on the second day can there be a high pulse of up to 103 in a patient after surgery under general anesthesia. What medications should I take? Is this normal? Patient age: 45 years

Consultation with a doctor on the topic “High blood pressure after surgery”

Hello, Svetlana! It’s not entirely clear - after all, the patient has an elevated pulse or blood pressure - the text of the question states one thing, the table of contents says something else.

In order to answer the question “why is the pulse increased?” you need to have information about the patient’s somatic pathology, the state of the thyroid gland, body temperature, blood pressure level, were there any complications during the operation (extensive blood loss), what kind of operation was it, what kind of the volume of the operation has been completed. You need to know the ECG result (what exactly is the rhythm).

If the patient did not have any somatic pathology, the condition of the thyroid gland is not disturbed, the patient has normal body temperature, normal blood pressure, the patient has not had blood loss, only sinus tachycardia is recorded on the ECG, he has no other complaints - in order to reduce the heart rate level You can take a Coraxan tablet 5-7.5 mg.

If there are any other changes, the attending physician must decide on the development of tachycardia and methods for stopping it after a direct examination and performing an ECG.

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Is it possible to do general anesthesia for heart disease?

Of course, a complete blackout caused by the use of anesthetics affects the body in one way or another. If a person is completely healthy, then most likely he has nothing to fear, and the use of anesthetics will not have any consequences. But is there any reason to worry for people with heart disease? In this article we will talk about whether general anesthesia is possible for various diseases hearts.

Is it possible to do general anesthesia for tachycardia?

In itself, tachycardia is not an absolute contraindication to the use of this type of anesthesia during surgery. Before giving this type of anesthesia to a patient with tachycardia, the anesthesiologist will administer premedication to regulate the patient’s heart rhythm. In addition, before giving an anesthetic, the doctor will check the results of an electrocardiogram, ultrasound of the heart, and Holter monitoring. If there are no organic heart diseases, general anesthesia can be used. If the results of such studies are not in the patient’s record, the doctor will ask you to undergo them.

Tachycardia can also occur as a complication after general anesthesia. In this case, additional quinine medications are prescribed to normalize heart function.

General anesthesia for bradycardia

Bradycardia is a slow heartbeat when the heart rate is less than 60 beats per minute. But anesthesia (narcosis) for bradycardia is contraindicated if the number of contractions is less than forty. Therefore, the patient needs to undergo ECG studies before surgery to determine the heart rate more accurately.

If the frequency is below normal, the cardiologist finds out the cause of the disease and prescribes treatment, after which, when the indicators stabilize, it is already possible to perform an operation with complete loss of consciousness.

Mitral valve prolapse and anesthesia

The possibility of performing an operation under general anesthesia in a patient with a disease such as mitral valve prolapse is determined by a combination of various medical indicators. First of all, these are, of course, the results of an ECG and ECHO, which will show the degree of the disease; the doctor also looks at the general condition of the body and concomitant diseases. As a result, a decision is made for a specific patient.

For example, if a patient has first-degree mitral valve prolapse and no concomitant diseases, this issue is resolved positively.

Low blood pressure anesthesia

There are no contraindications to the use of this type of anesthesia for low blood pressure. The patient can safely undergo surgery, since low blood pressure is successfully regulated by infusion therapy, and the anesthesiologist will monitor the indicators throughout the surgical procedure.

Anesthesia for high blood pressure

It is not an absolute contraindication. The anesthesiologist, depending on the duration and complexity of the operation, will assess all the risks and make a decision. As a rule, planned operations with complete loss of consciousness in case of high blood pressure are not performed. Before surgery, the patient returns his parameters to normal with the help of special therapy. If the operation is urgent, the specialist will constantly monitor blood pressure levels, using regulating medications at the slightest deviation from the norm.

High blood pressure can also manifest itself after anesthesia. In this case, the doctor will prescribe a course of treatment, and, most likely, will advise proper nutrition, giving up bad habits and physical exercise(if such a possibility exists).

Is it possible to do anesthesia after a heart attack?

If the patient suffered an acute myocardial infarction less than six months ago, then, on the issue of complete loss of sensitivity during a planned operation, the doctor’s decision will be negative. However, if urgent surgical intervention is required, and most importantly, there is a significant risk to a person’s life, this type of pain relief is still possible.

Anesthesia after stroke

As for a stroke, the situation here is exactly the same as with a heart attack. A stroke suffered less than six months ago is an absolute contraindication to the use of this type of pain relief. However, as in the previous case, if the risk to the patient’s life is high enough, the operation will be performed with complete loss of consciousness.

The risk of stroke after general anesthesia exists in elderly patients, especially if brain damage has already occurred. Danger exists if the operation is urgent and long-term, if it is performed on the brain, neck, heart or carotid artery, and also if the patient has heart and lung diseases.

Anesthesia is not harmless. Not everyone who is planning to undergo surgery knows this fact. The fact is that anesthesia, in addition to its direct purpose - to relieve a person of the sensation, has its downside: various complications often arise after it. We will look at them in this article.

Complications

All complications after anesthesia can be divided into early and late. Immediately after the operation, without leaving the narcotic state, a person can get a cerebral coma, even death. This happens extremely rarely, but such a possibility should not be excluded.

Later complications may appear for several weeks after surgery under anesthesia. These include:

pain that cannot be relieved by any painkillers other than narcotic painkillers;
dizziness that continues around the clock;
so-called panic attacks that occur almost daily;
partial memory loss;
frequent and severe cramps of the calf muscles;
negative impact on heart function - high blood pressure and other heart failures;
the occurrence of problems with the liver and kidneys, since they are the ones who cleanse the body of the toxic effects of anesthesia.

How to prevent possible complications after anesthesia?

Is it possible to prevent complications after undergoing anesthesia? Yes, it's possible.
You should know that after general anesthesia you need to take drugs like Cavinton or Piracetam, which promote rapid restoration of brain function and prevent possible headaches or memory problems.

In addition, after leaving the hospital, it is necessary to have an electrocardiogram, as well as a general exam and visit a therapist with the results.

Panic attacks, an uncontrollable feeling of fear that sometimes appears as a result of anesthesia, can be overcome by psychotherapists, and there is no need to be embarrassed to visit them.

And lastly: for minor surgical interventions, for example, treatment and extraction of teeth, you should not undergo general anesthesia - it is quite possible to get by with local anesthesia, so as not to “make” yourself unnecessary problems and diseases.

24.07.2007, 11:08

At the dentist's appointment they gave me anesthesia, and my blood pressure rose sharply to 180/110. I am seeing a cardiologist. I drink egilok, preductal and tritace. I need to go to the dentist soon. What should I tell the doctor, what kind of anesthesia can I have? Can I take tests for intolerance? My cardiologist says that I can’t take adrenaline.

24.07.2007, 18:44

Blood pressure does not always increase during local anesthesia due to the adrenaline contained in the anesthetic. The anxiety of a patient suffering from hypertension may have an effect. Some patients, for some unknown reason, decide not to take antihypertensive drugs before visiting the dentist, which they take daily - this is another reason for the rise in blood pressure. And much less common is such a complication as administering the drug into the vascular bed - when the doctor accidentally ends up with the tip of the needle into the vessel. Sometimes - if a non-carpul (ready-made) anesthetic is used - the solution may be prepared incorrectly, with a higher concentration of adrenaline.
A vasoconstrictor (adrenaline) greatly increases the effectiveness of the local anesthetic and significantly increases its duration of action. Insufficient pain relief is more likely to lead to a rise in blood pressure than adrenaline itself.
The vast majority of anesthetic substances used in practice have the property of dilating blood vessels. This leads to their rapid absorption into the bloodstream and destruction - and, accordingly, to a shorter duration and effectiveness of anesthesia. Mepivacaine does not dilate blood vessels. There are also carpule anesthetics with a lower adrenaline content (ultracaine-DS, for example).

Tests are carried out to identify allergies to any substance, so in the case of adrenaline this is meaningless, and an increase in blood pressure for adrenaline is not even a side effect, but a direct effect due to its properties.

It turned out to be a lot of buffoonery...

25.07.2007, 10:56

The anxiety of a patient suffering from hypertension may have an effect. Some patients, for some unknown reason, decide not to take antihypertensive drugs before visiting the dentist, which they take daily - this is another reason for the rise in blood pressure.

Thank you.
There was no excitement, because I had been going to the dentist for six months already, once a week. like going to your home. I came that time, they gave me an injection, they said let’s go and have some tea, and you, Tanyush, would you like to read a magazine. I read, I smell - one eye is taken away and cannot see, then the brain seems to have become cottony, and then the second eye. and then the nurse happened to look in, and I felt completely ill. Before taking any medications for blood pressure, (and a month before that I started taking Eutirox), because before that I did not suspect that I had high blood pressure. It turns out then that it was elevated for me. Although this has never happened before under anesthesia. Endocrinologists tell me that an increase in blood pressure cannot be associated with taking thyroxine, but somehow everything started synchronously with taking eutyrox.
In short, I’ve already had enough of all the doctors here.....

25.07.2007, 14:44

25.07.2007, 15:32

You mentioned the eye. I conclude that you had treatment on one of your maxillary molars. When numbing these teeth, an anesthetic is injected into a place with a dense venous plexus. The risk of the anesthetic entering the bloodstream is quite high. There was probably a vascular reaction to a vasoconstrictor in this case.

Nope, lower jaw, penultimate tooth (in terms of location, not in general)))))

25.07.2007, 15:35

Before that, an anesthesia injection was given in the same place, then my eye also became numb and would not close, that is, it was generally as if it were dead, the eyelid did not obey... I closed the eyelid with my fingers so that the eye would not dry out. Some kind of horror. It lasted about 6 hours later.

25.07.2007, 16:06

hmm..interesting

25.07.2007, 21:43

26.07.2007, 09:19

Tatyana, this sometimes happens when not only the sensory, but also the motor branches of the nerves are involved in the zone of action of the anesthetic. Not comfortable, but goes away with the effect of anesthesia
With the anesthesia that you were given, there is also the possibility of the needle getting into the vessel. For example, this happened in my practice. Did you feel like a hot wave ran down your face?

I don’t remember about the hot wave, to be honest..
It turns out that if they get into the vessel again, the same situation could happen? Is it possible to do all the teeth at once under general anesthesia? I woke up and all my teeth were cured))))

26.07.2007, 10:20

26.07.2007, 11:22

Tatyana, tell me, how long did you have to treat that lower tooth before you needed anesthesia?

When the pressure jumped, they hadn’t even started to treat the tooth yet; when I came, they immediately gave me an injection.
And the one when the eye could not move for a long time - about an hour, in my dentistry any appointment lasts an hour. I hope I understood your question correctly.

26.07.2007, 11:39

26.07.2007, 11:48

Yes, that's right. Do you think they will treat each tooth for an hour under anesthesia?

Then I will have to lie there for a day.

Normally, blood pressure is always low after general anesthesia. This is due to the principle of action of drugs used for pain relief. They inhibit the activity of the nervous system, as a result, all processes in the body slow down. Since the nervous system needs time to recover, on the first day after general anesthesia, loss of strength and dizziness are possible, caused by a decrease in pressure by 15-20 mmHg. compared to normal levels for humans.