More Hemodynamic Changes in Hypertensive Versus Non-hypertensive Patients Undergoing Breast Cancer Surgery in General Anesthesia - a Prospective Clinical Study

Aim Preoperative comorbidity may significantly influence the conduction of anesthesia and patients’ outcome. The aim of this study was to compare a number of anesthetic interventions and the use of non-anesthetic drugs in hypertensive and non-hypertensive patients during general anesthesia for moderately invasive surgery. Methods A total number of 88 elective hypertensive (n = 44) and non-hypertensive (n = 44) breast cancer patients were enrolled in the prospective study. Midazolam and infusion of normal saline were given before anesthesia. Etomidate, rocuronium, fentanyl, and sevoflurane up to the 1 MAC were used for the maintenance of anesthesia. Mean arterial pressure (MAP), pulse, core temperature and intraoperative use of all drugs were recorded. MAP was maintained by sevoflurane and infusion replacement. Urapidil and ethylephrine were given if MAP differed > or <30% of baseline, and atropine if heart rate <50 beats min-1. A statistical analysis was made using chi-square and Mann-Whitney tests. Results The highest MAP was 133±19.3 in hypertensive and 122±16.5 mmHg in the non-hypertensive patients (p 0.05). Intraoperative bradycardia (11/44 vs.7/44) and atropine applications (16 vs. 9, ns, p> 0.05) were similar in two groups. Conclusion Hypertensive patients required more anesthetic interventions and had higher consumption of vasoactive drugs during anesthesia for breast cancer surgery, suggesting their hemodynamic instability possibly related to the hypertensio