HYPOTENSION AND HYPERTENSION AS CONSEQUENCES OF BARORECEPTOR DYSFUNCTION FOLLOWING CAROTID ENDARTERECTOMY

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  • 1 January 1979
    • journal article
    • research article
    • Vol. 85  (6) , 633-637
Abstract
Arterial pressure regulation is often labile following carotid endarterectomy. Hemodynamic data from 100 endarterectomies defined 3 distinct postoperative blood pressure responses. A hypotensive response (group 1) affected 28 patients in whom mean arterial pressure decreased from 168 .+-. 29/90 .+-. 15 mm Hg before operation to 110 .+-. 21/68 .+-. 16 mm Hg after operation (P < 0.001). Maximum hypotension occurred 5.3 h after endarterectomy. Preoperative pulse, 80 .+-. 9 beats/min, fell to a low of 64 .+-. 12 beats/min after operation (P < 0.001). A significant hypertensive response (group II) affected 19 patients in whom mean blood pressure rose from 160 .+-. 29/87 .+-. 15 to 223 .+-. 32/110 .+-. 22 mm Hg (P < 0.001). Maximum hypertension was noted 2.3 h after endarterectomy. This was unaccompanied by significant pulse changes. Fifty-three patients remained normotensive (group III). Their preoperative blood pressure (150 .+-. 21/88 .+-. 12 mm Hg) was unaltered by carotid endarterectomy (149 .+-. 25/87 .+-. 14 mm Hg). Fluctuations in pressure did not correlate with age, indication for operation or degree of ipsilateral and contralateral carotid arterial stenosis. Postendarterectomy hypotension and hypertension appear to represent transient baroreceptor dysfunctions.