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Chapter: Clinical Anesthesiology: Anesthetic Management: Anesthesia for Patients with Cardiovascular Disease

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Hypertension: Postoperative Management

Postoperative hypertension is common and should be anticipated in patients who have poorly con-trolled hypertension.

POSTOPERATIVE MANAGEMENT

Postoperative hypertension is common and should be anticipated in patients who have poorly con-trolled hypertension. Close blood pressure moni-toring should be continued in both the recovery room and the early postoperative period. In addi-tion to myocardial ischemia and congestive heart failure, marked sustained elevations in blood pressure can contribute to the formation of wound hematomas and the disruption of vascular suture lines.

Hypertension in the recovery period is often mul-tifactorial and enhanced by respiratory abnormali-ties, anxiety and pain, volume overload, or bladder distention. Contributing causes should be corrected and parenteral antihypertensive agents given if nec-essary. Intravenous labetalol is particularly useful in controlling hypertension and tachycardia, whereas vasodilators are useful in controlling blood pressure in the setting of a slow heart rate. When the patient resumes oral intake, preoperative medications should be restarted.

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