Postoperative hypertension

Postoperative hypertension is common, occurring in 15 to 45 per cent of patients, but is usually short-lived. Its adverse effects include increased myocardial oxygen demand, decreased left ventricular performance, myocardial ischemia or infarction, graft and suture line disruption, and increased bleeding. After adequate analgesia and anxiolysis, optimization of circulating volume, and attention to rewarming, parenteral treatment is with vasodilators (nitrates, sodium nitroprusside, hydralazine, or phentolamine). Calcium-channel blockers and angiotensin-converting enzyme inhibitors may be needed later if hypertension persists beyond the immediate postoperative period.

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