ArticleJournal of anesthesia2023
Post-induction hypotension and intraoperative hypotension as potential separate risk factors for the adverse outcome: a cohort study.
Article in Journal of anesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07022730 (The Novel Use of Prophylactic Noradrenaline Infusion and Its Impact on Post-induction Hypotension in Patients With Surgical Sepsis, a Double Blind Randomized Controlled Trial), which is not on this map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Novel Use of Prophylactic Noradrenaline Infusion and Its Impact on Post-induction Hypotension in Patients With Surgical Sepsis, a Double Blind Randomized Controlled Trial
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Preoperative patient risk factors for intraoperative hypotension: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- Preemptive noradrenaline infusion: a game-changer against post-induction hypotension in surgical sepsis: a randomized double blind trial.BMC anesthesiology · 2026Trial
- Intraoperative hypotension after remimazolam or propofol induction with sevoflurane maintenance in angiotensin II receptor blockers-treated patients: a randomized controlled trial.Scientific reports · 2025Trial
- A randomized trial evaluating hemodynamics during minor hepatectomy under general anesthesia combined with thoracic epidural anesthesia: remimazolam versus propofol.BMC anesthesiology · 2025Trial
- Effect of propofol combined with remimazolam besylate on blood pressure during general anesthesia induction in patients undergoing gynecological laparoscopic surgery: single-centre randomized controlled trial.BMC anesthesiology · 2025Trial
- Effects of oral clonidine on bleeding in pelvic and acetabular fractures surgery: a randomized controlled trial.BMC musculoskeletal disorders · 2025Trial
- Blood pressure thresholds for the administration of balanced crystalloids and the effect on intra-operative hypotension: A proof-of-concept causal inference analysis featuring idealised dynamic treatment regimens.European journal of anaesthesiology · 2026Observational
- Diagnostic accuracy of left ventricular outflow tract velocity time integral and subclavian vein/infraclavicular axillary vein collapsibility index for predicting post-induction hypotension in patients undergoing emergency surgery under general anaesthesia.Indian journal of anaesthesia · 2026Article
- Multicentre international observational study on airway management for anaesthesia: the STARGATE study protocol.BMJ open · 2026Observational
- Review
- A time-series clustering analysis of postinduction blood pressure trajectories.Scientific reports · 2026Article
- Effect of ciprofol on the incidence of hypotension during induction of general anesthesia in elderly patients undergoing total hip arthroplasty: single-center retrospective study.Frontiers in medicine · 2026Article
- Effect of deep analgosedation vs. intubated general anesthesia on perioperative sedation-related adverse events in older adults undergoing ERCP: protocol for a randomized controlled trial.Frontiers in medicine · 2026Article
- Acute kidney injury and postoperative delirium.Journal of biomedical research · 2025Article
- Article
- Developing a machine learning-based prediction model for postinduction hypotension.Journal of clinical monitoring and computing · 2025Article
- Preoperative Clear Fluid Fasting Duration and Arterial Hypotension During Anesthesia Induction: A Narrative Review.Journal of clinical medicine · 2025Review
- Risk factors for intraoperative hypotension during cardiac surgery.Indian journal of thoracic and cardiovascular surgery · 2025Article
- Key Risk Factors for Postoperative Hypotension in Nasopharyngeal Carcinoma Patients After Endoscopic Surgery: A Retrospective Study.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Association Between Perioperative Hypotension and Graft Function in Kidney Transplantation.Kidney international reports · 2025Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeIntraoperative hypotension (IOH) is associated with organ hypoperfusion. There are different underlying causes of IOH depending on the phase of surgery. Post-induction hypotension (PIH) and early-intraoperative hypotension tend to be frequently differentiated. We aimed to explore further different phases of IOH and verify whether they are differently associated with postoperative complications.
methodsPatients undergoing abdominal surgery between October 2018 and July 2019 in a university hospital were screened. Post-induction hypotension was defined as MAP ≤ 65 mmHg between the induction of anaesthesia and the onset of surgery. Hypotension during surgery (IOH) was defined as MAP ≤ 65 mmHg occurring between the onset of surgery and its completion. Acute kidney injury, stroke or transient ischaemic attack, delirium, and myocardial infarction were considered as the outcome.
resultsWe enrolled 508 patients (219 males, median age 62 years). 158 subjects (31.1%) met PIH, 171 (33.7%) met IOH criteria, and 67 (13.2%) patients experienced both. PIH time accounted for 22.8% of the total hypotension time and 29.7% of the IOH time. The IOH time accounted for 5.17% of the total intraoperative time, while PIH for 8.91% of the pre-incision time. Female sex, lower height, body mass and lower pre-induction BP (SBP and MAP) were found to be associated with the incidence of PIH. The negative outcome was observed in 38 (7.5%) patients. Intraoperative MAP ≤ 65 mmHg, longer duration of the procedure (≥ 230 min), chronic arterial hypertension and age were associated with the presence of the outcome (p < 0.01 each).
conclusionsThe presence of IOH defined as MAP ≤ 65 mmHg is relevant to post-operative organ complications, the presence of PIH does not appear to be of such significance. Because cumulative duration of PIH and IOH differs significantly, especially in long-lasting procedures, direct comparison of the influence of PIH and IOH on outcome separately may be biased and should be taken into account in data interpretation. Further research is needed to deeply investigate this phenomenon.
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Registered trials
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