Skip to main content
SpringerLink
Log in

Intraoperative Blood Pressure Lability Is Associated with Postoperative Hemorrhage after Uncomplicated Bariatric Surgery

  • Brief Communication
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Postoperative hemorrhage is a rare complication in bariatric surgery. We aim to determine if differences in blood pressure or perioperative medication administration contribute to postoperative bleeding in patients who were hemodynamically stable intraoperatively.

Methods

This was a retrospective case-control study of all bariatric surgery patients from 2014 to 2017 at a high volume academic center. We identified controls based on age, gender, ethnicity, type of procedure, and pre-operative blood pressure.

Results

Patients with postoperative hemorrhage had a significantly lower MAP during the portion of the surgery in which the abdominal contents were inspected for leaks and bleeds. The timing of enoxaparin or ketorolac administration was not associated with bleeding.

Conclusion

Blood pressure lability, but not enoxaparin or ketorolac administration, is associated with postoperative hemorrhage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Perioperative safety in the longitudinal assessment of bariatric surgery. New England Med. 2009;361(5):445–54. doi: https://doi.org/10.1056/NEJMoa0901836.

  2. Pannucci CJ, Wachtman CF, Dreszer G, et al. The effect of postoperative enoxaparin on risk for reoperative hematoma. Plast Reconstr Surg. 2012;129(1):160–8. https://doi.org/10.1097/PRS.0b013e318236215c.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Morton RP, Vandal AC. Postoperative systolic blood pressure as a risk factor for haematoma following thyroid surgery. Clin Otolaryngol. 2015;40(5):462–467. https://doi.org/10.1111/coa.12407

    Article  Google Scholar 

  4. Basali A, Mascha EJ, Kalfas I, et al. Relation between perioperative hypertension and intracranial hemorrhage after craniotomy. Anesthesiology. 2000;93(1):48–54.

    Article  CAS  Google Scholar 

  5. Janik MR, Rogula T, Kowalewski P, et al. Case-control study of postoperative blood pressure in patients with hemorrhagic complications after laparoscopic sleeve gastrectomy and matched controls. Obes Surg. 2017;27(7):1849–53. https://doi.org/10.1007/s11695-017-2569-x.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Moulin PA, Dutour A, Ancel P, et al. Perioperative thromboprophylaxis in severely obese patients undergoing bariatric surgery: insights from a French national survey. Surg Obes Relat Dis. 2017;13(2):320–6. https://doi.org/10.1016/j.soard.2016.08.497.

    Article  PubMed  Google Scholar 

  7. Klein M, Stockel M, Rosenberg J, et al. Intraoperative ketorolac and bleeding after laparoscopic Roux-en-Y gastric by-pass surgery. Acta Chir Belg. 2012;112(5):369–73.

    Article  CAS  Google Scholar 

  8. Javanainen MH, Scheinin T, Mustonen H, et al. Retrospective analysis of 3 different antithrombotic prophylaxis regimens in bariatric surgery. Surg Obes Relat Dis. 2016;12(3):675–80. https://doi.org/10.1016/j.soard.2015.12.017.

    Article  PubMed  Google Scholar 

  9. Levin MA, Fischer GW, Lin HM, et al. Intraoperative arterial blood pressure lability is associated with improved 30 day survival. Br J Anaesth. 2015;115(5):716–26. https://doi.org/10.1093/bja/aev293.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Lee D. Ying is supported through the Yale Medical Scientist Training Program and a National Research Service Award through the National Institute of Diabetes and Digestive and Kidney Diseases (NRSA: 1F30DK112569-01).

Author information

Authors and Affiliations

  1. Yale School of Medicine, New Haven, CT, USA

    Lee D. Ying, Andrew J. Duffy, Kurt E. Roberts, Saber Ghiassi, Matthew O. Hubbard & Geoffrey S. Nadzam

  2. Department of Gastrointestinal Surgery, Yale Medicine, New Haven, CT, USA

    Andrew J. Duffy, Kurt E. Roberts, Saber Ghiassi, Matthew O. Hubbard & Geoffrey S. Nadzam

Authors
  1. Lee D. Ying
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew J. Duffy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kurt E. Roberts
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Saber Ghiassi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthew O. Hubbard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Geoffrey S. Nadzam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lee D. Ying.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Statement

This was a retrospective study, which was approved by the Institutional Human Investigation Committee not required (ID: 2000021987) and was conducted in accordance with the ethical standards of this institution, the national research committee, as well as the 1964 Helsinki Declaration and its later amendments.

Informed Consent Statement

This was a retrospective study which was approved by the Institutional Human Investigation Committee and determined that formal consent was not required. The IRB protocol ID is 2000021987.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ying, L.D., Duffy, A.J., Roberts, K.E. et al. Intraoperative Blood Pressure Lability Is Associated with Postoperative Hemorrhage after Uncomplicated Bariatric Surgery. OBES SURG 29, 1990–1994 (2019). https://doi.org/10.1007/s11695-019-03839-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-019-03839-y

Keywords

Search

Navigation