Is there an effect of perioperative blood pressure on intraoperative complications during phacoemulsification surgery under local anaesthesia?
OBJECTIVE
The practice of deferring phacoemulsification procedure on recording raised blood pressure (BP) in the immediate perioperative period is based on the perception of increased intraoperative risk. The significance of perioperative BP recordings on the surgical complications during phacoemulsification procedure was evaluated.


METHODS
Hairmyres Hospitals, Lanarkshire Acute Hospitals NHS Trust.


METHODS
Patients were classified as hypertensive on the basis of the British Hypertension Society Guidelines. BP recordings during preoperative assessment, admission, and 1-hour postoperatively were recorded in 734 hypertensives and 740 normotensives undergoing phacoemulsification procedure. In addition, BP recordings in the holding area before giving local anaesthesia were noted in the 734 hypertensives. Patient's peri- and intraoperative complications during the procedure were noted.


RESULTS
The mean age was 72+/-10.5 years and 74+/-11.6 years among the hypertensives and normotensives. There was a significant increase in the number of hypertensives who developed isolated systolic hypertension in the holding area (95% confidence interval=2.82, P<0.001) where the mean BP was 171.38/78.31 mm Hg (+/-30.55/16.29). A total of 21 hypertensives and 18 normotensives developed intraoperative complications during the phacoemulsification procedure. There was no significant difference (P=0.41) in the intraoperative complications between the hypertensives and normotensives.


CONCLUSIONS
Perioperative increase in BP noted in the holding area among hypertensives did not increase the risk of surgical complications during phacoemulsification procedure when compared with normotensives. We recommend that BP should not be routinely measured in the holding area before phacoemulsification surgery under local anaesthesia.
Agarwal
P K
PK
Department of Ophthalmology, Hairmyres Hospitals, Lanarkshire Acute Hospitals NHS Trust, East Kilbride, Scotland, UK. pankaj_eye@yahoo.com
Mathew
M
M
Virdi
M
M
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002386:Cataract / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000503:physiopathology; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D018918:Phacoemulsification; D011300:Preoperative Care