Variation Of Patients’ Blood Pressure And Heart Rate In The Perioperative Period And Inlfuence Factor

Objective：1.To Observe the variations of blood pressure and heart rate within theperioperative period and time window the variation occurs in。2.To analyze the factors causing the variation and find out some common factorsaffecting the variations of blood pressure within the perioperative period.3. To remind clinicians of focusing on them and taking appropriate measures,make surgery carried out successfully and avoid some the associated conditionswithin the perioperative period.Methods：660patients suffering from four diseases were selected, including simple thyroid tumor,varicose veins of lower extremities, benign adenoma of mammary gland and hernias. Amongthem,283samples were male, while377were female. When admitted, the patients were surveyedby using questionnaire and self-rating anxiety scale(SAS), followed by calculating scores. Andthen, the patients with or without anxiety were identified according to the above scores, andunderlying diseases, educational background and being with or without bad habits of patientswere known. Routine examination were carried out, including detecting blood lipids, liverfunction, renal function, ECG, echocardiography, sternum and so on, in order to exclude thepatients with severe dysfunction of liver or kidney, hyperthyroidism and severecardio-cerebral-vascular diseases such as cerebral hemorrhage and cerebral thrombosis. Bloodpressure and heart rate of right upper arm of the supine patients were determined through digitalblood pressure monitor of OMRON with arm sleeves in room temperature. The time ofdetection were respectively on that day when admitted,7：00-8：00am in everymorning of three days before operaion,2:00-4:00pm one day before operaion,30minuted before operaion and7：00-8：00am in every morning of three days aferoperaion. SPS17.0statistical software was used. Statistical significances were analyzed byone-way analysis of variance followed by t-test used in comparisons between multiple groups.Results： (1)The changes of blood pressure and heart rate looked like peak shape within theperioperative period. Preoperative blood pressure rising gradually and reached thehighest point30minuted before operaion. Both the systolic pressure and the diastolicpressure were higher obviously than basic blood pressure（136±15VS.118±14，79±9VS.72±9，P<0.05respectively）. Heart rate after operation descended gradually andwere lower than basic status on the third day（72±7VS.79±7，P<0.05）,while therewere not changes of heart rate.(2)Systolic blood pressure of the patients with anxiety was highed than theanxiety-free by about an average of10mmHg and15mmHg30minutes beforeoperaion. The both decreased sharply on the first day after operation and reached theirbasic blood pressure. Changes of diastolic blood pressure and heart rate were similarwith systolic blood pressure（3）The changes of blood pressure and heart rate were compared among young,middle-aged and elderly patients within the perioperative period. Changes of bloodpressure in the elderly and the middle-aged were higher than young. However,changes of heart rate of young were higher than the middle-aged and elderly.（4）Blood pressure in patients with past history of hypertension was higher thanthose without past history of hypertension, but there were not obvious changes ofheart rate between both.（5）Both the systolic blood pressure and the diastolic blood pressure of the malewere higher markedly than the female, while the changes of heart rate in the femalewere higher than the male.（6）Multiple regression analysis revealed that changes of perioperative bloodpressure were related closely to anxiety, age, previous history of hypertension andeducation background, especially anxiety（P=0.001）.Conclusions:1、Blood pressure and heart rate of all patients are elevated significantly beforeoperation, especially in the elderly and the patients with hypertension.2、There are certain relations between changes of perioperative blood pressure andheart rate and gender, especially in female compared to male. Meanwhile, changes ofblood pressure is not related linearly to heart rate. 3、the patient’s cognitive levels also affect fluctuation of blood pressure, while anxietyis one of the most important factors affecting fluctuation of blood pressure.