Audit of Intraoperative Hypertension Management in 75 Patients at THQ Hospital Sadiq Abad
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Background
Intraoperative hypertension (IOH) is a frequent anesthetic challenge linked to myocardial ischemia, arrhythmias, cerebrovascular events, and increased surgical bleeding. Despite its impact, structured evaluation of IOH management is inconsistent, especially in resource-limited hospitals.
Objective
To evaluate recognition, documentation, precipitating causes, and management of IOH at THQ Hospital Sadiq Abad, and to identify gaps relative to accepted standards.
Methods
A retrospective audit of 75 adult patients (18–75 years) with documented IOH episodes from January to June 2025 was conducted. Data extracted from anesthesia records included demographics, ASA grade, type of surgery, anesthetic technique, recorded trigger(s), interventions, and immediate outcomes. Audit standards were adapted from the Association of Anaesthetists’ peri-operative hypertension guidance. Descriptive statistics were used to summarize findings and guide recommendations.
Results
IOH was documented in all 75 cases (100%). A precipitating cause was recorded in 52%. The most common first-line response was deepening anesthesia (42%), followed by opioid boluses (28%) and antihypertensives (16%). Targeted correction of reversible triggers (e.g., bladder decompression, ventilatory adjustment) was documented in 14%. No peri-operative mortality occurred; however, prolonged IOH (>15 minutes) was noted in a minority of cases.
Conclusion
While recognition of IOH was universal, documentation of triggers and targeted, protocolized management were suboptimal. Introducing a structured proforma, theatre-posted algorithms, and focused teaching—followed by re- audit in 6–12 months—may improve patient safety.
