title: Vigilance of hemodynamic changes immediately after transferring patients is crucial.
abstract: OBJECTIVE
  A decrease in blood pressure is sometimes observed when a postsurgical patient is transferred to another bed after recovering from anesthesia. However, the mechanism behind this hypotension has not been completely elucidated. The purpose of this study was to investigate and compare changes in hemodynamic properties for possible causes of hypotension before and after transfer to another bed of postsurgical patients receiving general anesthesia, combined epidural and general anesthesia, or combined spinal and general anesthesia.
  
  
  METHODS
  We studied 69 patients undergoing elective surgery who were randomized to receive anesthesia by one of the three methods. After surgery, the tracheal tube was removed, and each patient was transferred to another bed. Hemodynamic data recorded immediately before and after transfer of the patient to another bed were compared.
  
  
  RESULTS
  After transfer of patients receiving general anesthesia or combined epidural and general anesthesia, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and cardiac output (CO) decreased; heart rate (HR) and systemic vascular resistance (SVR) did not change. However, after transfer of patients receiving combined spinal and general anesthesia, SAP, DAP, HR, and CO decreased, but SVR did not change.
  
  
  CONCLUSIONS
  The decrease in blood pressure observed after transfer of a postsurgical patient to another bed after general, combined epidural and general, and combined spinal and general anesthesia was associated with a decrease in CO and no change in SVR, but HR decreased after combined spinal and general anesthesia, whereas it was unchanged after general and combined epidural and general anesthesia. The decrease in blood pressure is assumed to be caused by a decrease in venous return, and several reflexes might participate in this decrease of blood pressure, especially after combined spinal and general anesthesia.
authors: Department of Anesthesiology, Shioya Hospital, International University of Health and Welfare, Tomita 77, Yaita-shi, Tochigi, 329-2145, Japan. HFB01245@nifty.com
authors: Zen'ichiro
authors: Z
authors: Wajima
authors: Toshiya
authors: T
authors: Shiga
authors: Kazuyuki
authors: K
authors: Imanaga
authors: Tetsuo
authors: T
authors: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D062186:Arterial Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D055805:Moving and Lifting Patients / Q000379:methods*; D011184:Postoperative Period; D014655:Vascular Resistance / Q000187:drug effects