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Vigilance of hemodynamic changes immediately after transferring patients is crucial

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Abstract

Purpose

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.

Conclusion

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.

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Author information

Author notes

  1. Kazuyuki Imanaga

    Present address: Department of Anesthesia, Shonan Kamakura General Hospital, Kanagawa, 247-8533, Japan

Authors and Affiliations

  1. Department of Anesthesiology, Shioya Hospital, International University of Health and Welfare, Tomita 77, Yaita-shi, Tochigi, 329-2145, Japan

    Zen’ichiro Wajima

  2. Department of Anesthesiology, International University of Health and Welfare Hospital, Tochigi, 329-2763, Japan

    Zen’ichiro Wajima

  3. Department of Anesthesiology, Kaken Hospital, Chiba, 272-0827, Japan

    Toshiya Shiga

  4. Division of Cardiovascular Anesthesia, Department of Anesthesia, New Tokyo Hospital, Chiba, 271-0077, Japan

    Kazuyuki Imanaga

  5. Department of Anesthesia, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, 270-1694, Japan

    Tetsuo Inoue

Authors
  1. Zen’ichiro Wajima
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  2. Toshiya Shiga
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  3. Kazuyuki Imanaga
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  4. Tetsuo Inoue
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Corresponding author

Correspondence to Zen’ichiro Wajima.

Additional information

Part of this work was presented at the American Society of Anesthesiologists 2010 Annual Meeting (San Diego, CA, USA).

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Wajima, Z., Shiga, T., Imanaga, K. et al. Vigilance of hemodynamic changes immediately after transferring patients is crucial. J Anesth 27, 521–527 (2013). https://doi.org/10.1007/s00540-013-1568-x

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  • DOI: https://doi.org/10.1007/s00540-013-1568-x

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