Observational studyJournal of anesthesia2026
Relationship between duration of intraoperative hypotension and postoperative delirium in patients undergoing head and neck cancer surgery with free flap reconstruction: a retrospective observational study.
Observational study in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Reply to the letter by Eylem Yaşar et al.Journal of anesthesia · 2026Article
- Reply from authors: relationship between duration of intraoperative hypotension and postoperative delirium in patients undergoing head and neck cancer surgery with free flap reconstruction: a retrospective observational study.Journal of anesthesia · 2026Article
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Abstract
purposePostoperative delirium (POD) is a frequent complication after surgery, especially in elderly patients undergoing head and neck cancer surgery with free flap reconstruction. This study aimed to assess the associations between intraoperative hypotension (IOH), its duration, and occurrence of POD.
methodsThis retrospective study included 239 patients aged 65 years or older who underwent head and neck cancer surgery with free flap reconstruction. IOH was defined at seven mean arterial pressure (MAP) thresholds, ranging from 55 to 85 mmHg, in 5 mmHg increments. The duration of each IOH was compared between patients with or without POD before and after initiation of microsurgery. Multivariate analysis was conducted to assess the independent association of each IOH duration with the risk of POD.
resultsPOD occurred in 43 (18.0%) of the 239 patients. Before the initiation of microsurgery, the cumulative duration of hypotension below MAP thresholds of < 70 to 80 mmHg was significantly longer in patients with POD. After the initiation of microsurgery, the cumulative duration of hypotension below MAP thresholds of < 55 to 85 mmHg was also significantly longer in patients with POD. In multivariate analysis, the cumulative duration of hypotension below MAP thresholds of 70, 75, and 80 mmHg before and after the initiation of microsurgery was independently associated with POD (p < 0.05 at each threshold).
conclusionProlonged IOH, particularly below MAP thresholds of 70, 75, and 80 mmHg, was significantly associated with POD in elderly patients undergoing head and neck cancer surgery with free flap reconstruction.
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