ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2021
Risks of adverse events in patients with orthostatic intolerance undergoing surgery with general anesthesia.
Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors at 4 institutions in 2 countries.
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Abstract
introductionOrthostatic intolerance (OI) is a group of disorders characterized by symptoms that occur upon standing and resolve with recumbence. Although well established but not widely recognized, these diagnoses may create uncertainty for clinicians dealing with a patient affected by OI and requiring a surgical procedure.
objectivesTo determine the rate of intra- and postoperative major adverse events in patients with OI undergoing surgery with general anesthesia.
methodsThe study was a retrospective study of patients with orthostatic intolerance who underwent surgery requiring general anesthesia from 1 January 2000 to 31 December 2018.
resultsA total 171 patients with OI underwent 190 surgeries. In patients with POTS and orthostatic-induced VVS, there were no major significant adverse events. There was one episode of AVNRT in a patient with POTS and one episode of bradycardia secondary to vasovagal reflex in a patient with orthostatic-induced VVS. Moreover, there were 13 (6.8%) episodes of postoperative hypotension. However, the majority of these episodes were related to bleeding, volume depletion or sepsis. All cases of hypotension responded well to appropriate therapy. In patients with OH, the rate of postoperative major adverse cardiac events was 4.7%, and the 30-day mortality rate was 6.1%. This is not significantly different from the calculated risk for patients without OH. There were no myocardial infarctions or deaths at 30 days in patients with POTS or orthostatic-induced VVS.
conclusionPatients with OI may not experience higher rates of perioperative complications compared with patients without OI syndromes.
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