Comparison of VAS score in patients administered with the general and regional anesthesia diagnosed with the hypertension undergoing surgeries
Dr. Bhuvneshwar Kumar, Dr. Satyeshwar Jha, Dr. Kiran Bharati
With changing lifestyles and an increasing older population, anaesthesiologists are likely to encounter more patients with comorbid illnesses presenting for elective surgery. In the US, hypertension accounts for >30% of individuals >20 years, with increasing prevalence in older individuals (50% of individuals aged > 65 years) and a slight male: female preponderance. In India, the prevalence of hypertension is 28%–32% in the urban population and 27.6% in the rural population. Hypertension being mostly asymptomatic, there is an increased probability of diagnosing it during a routine pre-operative assessment. Data from western countries reveal that the incidence of hypertension in pre-operative patients ranges from 10% to 25%. Hence based on above findings the present study was planned for Comparison of VAS Score in Patients Administered with the General and Regional Anesthesia Diagnosed with the Hypertension Undergoing Surgeries. The present study was planned in Department of Anaesthesia, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India. Total 30 patients diagnosed with the hypertension undergoing surgeries under general and regional anesthesia were enrolled in the present study. General anesthesia was initiated with Fentanyl 2µg kg-1 and propofol 2.5 mg kg-1. Anesthesia was kept up with 0.7-1.5% end-tidal sevoflurane after orotracheal intubation encouraged by atracurium 0.5 mg kg-1. Regional anaesthesia was administered using spinal block with a 25 Gauge spinal needle between the L3–L4 intervertebral spaces. Regional anaesthesia was achieved by 3.2ml-3.6ml accordingly hyperbaric bupivacaine injection. Hypertension is a modifiable risk factor for cardiovascular diseases and outcomes, and the same is true of the patient presenting for surgery. Adequate blood pressure control must be maintained in all three perioperative (pre, intra and postoperative) settings, as its instability is associated with multiple adverse events. There is increased intra-operative fluctuations and reduced post-operative pain among the patients in the regional anaesthesia group in comparison to those under general anaesthesia group.