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
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.