Srpski arhiv za celokupno lekarstvo 2018 Volume 146, Issue 3-4, Pages: 163-168
https://doi.org/10.2298/SARH170522156S
Full text ( 196 KB)
Risk factors for intraoperative variatons in blood pressure and cardiac dysrhythmia during thyroid surgery
Stojanović Marina (Faculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Kalezić Nevena (Faculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade + Clinical Center of Serbia, Center for Endocrine surgery, Belgrade)
Miličić Biljana (Faculty of Dentistry, Belgrade)
Tošković Anka (Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Stevanović Ksenija (Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Antonijević Vesna (Clinical Center of Serbia, Center for Anaesthesiology and ressuscitation, Belgrade)
Lakićević Mirko (Clinical-Hospital Center “Zemun”, Belgrade)
Bagi Bojan (General Hospital, Subotica)
Živaljević Vladan (Faculty of Medicine, Belgrade + Clinical Center of Serbia, Center for Endocrine surgery, Belgrade)
Introduction/Objective. Intraoperative variations in blood pressure and/or
cardiac dysrhythmias (IOVBP/CD) represent one of the most common causes of
morbidity and mortality in surgical patients. The aim of the study was to
determine the incidence and risk factors for IOVBP/CD in thyroid surgery
patients with comorbidities. Methods. The study included 1252 euthyroid
patients with ASA 2 and ASA 3 status who underwent thyroid surgery. The
following risk factors were examined: gender, age, body mass index (BMI), ASA
status, admission diagnoses, type of operation, duration of surgery, time
under general anesthesia, difficult intubation of trachea and coexisting
diseases: hypertension, cardiomyopathy (CMP), cardiac arrhythmias, angina
pectoris, diabetes mellitus (DM), kidney disease. Following intraoperative
events were recorded: hypertension, severe hypertension, hypotension and
cardiac arrhythmias. We used Pearson chi-square test, univariate and
multivariate logistic regression for statistical analysis. Results. The
majority of patients were female (86.3%). In 903 (72.1%) patients IOVBP/CD
were detected. The most common problem was intraoperative hypertension 61.4%.
Eight risk factors for IOVBP/CD were registered by univariate analysis:
advanced age, ASA 3 status, BMI>25kg/m2, duration of surgery, time under
general anaesthesia, hypertension and cardiomyopathy as coexisting disease.
The multivariate regression model identified three independent predictors for
IOVBP/CD: age, hypertension and cardiomyopathy. Conclusion. IOVBP/CDs are
common in thyroid surgery. The most common is intraoperative hypertension.
Older age, hypertension and cardiomyopathy as a coexisting disease are
independent risk factors for IOVBP/CD.
Keywords: : thyroidectomy, hypotension, hypertension, arrhythmias, cardiac
Project of the Serbian Ministry of
Education, Science and Technological Development, Grant no.175042