Variation of blood pressure during topical phacoemulsification

Abstract

Background The changes of blood pressure in patients undergoing cataract procedure are not well studied. The blood pressures of cataract patients often become uncontrolled intraoperatively causing the procedure to be postponed. Intraoperative rise in blood pressure has been associated with ocular complications such as suprachoroidal haemorrhage and can be fatal from stroke or even myocardial infarction. We attempt to study the changes in blood pressure of patients undergoing cataract surgery. Aim Prospective study on the variation of blood pressure pre-and intra-operatively. Method The blood pressure readings of patients going for cataract procedures were measured in five stages during the pre-assessment clinic, on arrival at the day surgery, at the anaesthetic room, on the operating table intraoperatively; and postoperatively. The readings were compared to their age, sex, past medical history, and use of antihypertensive medication. Results The rise in systolic blood pressures between intraoperative readings and those at the preassessment and anaesthetic room was highly statistically significant. Being older (465 years of age), taking more than two antihypertensive drugs, being hypertensive, or having a family history of hypertension does not appear to increase the risk. Conclusion Our study showed that there is a significant rise in systolic blood pressures especially in females during topical phacoemulsification. Further studies are needed on the factors that determine this increase and the changes in blood pressures during different stages of the procedure.

Is perioperative blood pressure monitoring during intravitreal injections important?

“…[1][2][3] A perioperative rise in blood pressure (BP) has been noted during cataract surgery. [4][5][6][7][8] In fact, the guidelines from the American Academy of Ophthalmology suggest that BP monitoring should be performed during cataract surgery by personnel, other than the operating ophthalmologist, who is qualified to monitor and manage the patient's systemic status. 9,10 In addition to the intraoperative BP rise, intravitreal anti-VEGF injections have been demonstrated to increase the lifelong risk of cardiovascular and cerebrovascular events.…”

Successful Surgical Management of Massive Suprachoroidal Haemorrhage Complicating Phacoemulsification

“…In this case, though the only risk factor noted preoperatively was older age, there could have been an increase in patient's systemic blood pressure during surgery. Yap et al have previously shown that there is a significant rise in systolic blood pressure especially in females during topical phacoemulsification [6].…”

Anesthesiologist Intervention during Cataract Surgery under Topical or Peribulbar Anesthesia: A Propensity Model Comparison

“…This contributed to the increasing popularity of TA for cataract surgery, together with the rapid postoperative recovery it warrants (34,35) and the good level of analgesia it provides (3,36). Nevertheless, cardiovascular instability and psychomotor agitation have been reported with TA (32,37,38) and in a previous randomized study patients significantly preferred PA over TA (14). Other studies that randomly compared PA and TA during cataract surgery reported a similar incidence of complications and suggest that TA may be preferable (17)(18)(19).…”