ORIGINAL ARTICLE   

Chirurgia 2021 October;34(5):193-8

DOI: 10.23736/S0394-9508.20.05179-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Effects of intraoperative hypotension on postoperative renal function in arthroscopic shoulder surgery: a retrospective study

Chaeseong LIM, Seounghun LEE, Woosuk CHUNG, Hoseop KIM, Seungbin JEON, Yoon-Hee KIM ✉

Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon, South Korea

BACKGROUND: Arthroscopic shoulder surgery tends to cause a drop in blood pressure due to the sitting position used during the procedure, including activation of the Bezold-Jarisch reflex. We hypothesized that patients with low blood pressure undergoing arthroscopic shoulder surgery in the sitting position would also have reduced renal function after surgery.
METHODS: The medical records of patients (N.=643) undergoing arthroscopic shoulder surgery in the sitting position between July 2013 and May 2015 were examined. The vital signs were measured at 5-minute intervals, and the number of non-invasive blood pressure (NIBP) measurements in the upper arm dropping below a mean arterial pressure (MAP) of 50 mmHg (MAP50) or 60 mmHg (MAP60) were recorded. The primary outcome was change in creatinine immediately after surgery relative to the preoperative level (Cr post/pre). The factors affecting Cr post/pre were examined by correlation analysis.
RESULTS: A total of 597 patients were included in the analysis. Longer duration of hypotension during surgery (MAP50) was correlated with higher Cr post/pre (R=0.107, P=0.010). However, the correlation between MAP60 and Cr post/pre was not significant (R=0.033, P=0.431).
CONCLUSIONS: It is necessary to ensure that the MAP does not fall below 50 mmHg to ensure sufficient renal function during general anesthesia for shoulder arthroscopy in a sitting position.

KEY WORDS: Sitting position; Creatinine; Hypotension; Surgical procedures, operative