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Risks of adverse events in patients with orthostatic intolerance undergoing surgery with general anesthesia

Ruzieh, Mohammed ; Sacks, Cody D ; Grewal, Simran S ; Aboujamous, Nader M ; Grubb, Blair P and Fedorowski, Artur LU orcid (2021) In Clinical autonomic research : official journal of the Clinical Autonomic Research Society 31(2). p.231-237
Abstract

INTRODUCTION: Orthostatic 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.

OBJECTIVES: To determine the rate of intra- and postoperative major adverse events in patients with OI undergoing surgery with general anesthesia.

METHODS: The study was a retrospective study of patients with orthostatic intolerance who underwent surgery requiring general anesthesia from 1 January 2000 to 31 December 2018.

RESULTS: A total 171 patients with OI underwent 190 surgeries. In patients... (More)

INTRODUCTION: Orthostatic 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.

OBJECTIVES: To determine the rate of intra- and postoperative major adverse events in patients with OI undergoing surgery with general anesthesia.

METHODS: The study was a retrospective study of patients with orthostatic intolerance who underwent surgery requiring general anesthesia from 1 January 2000 to 31 December 2018.

RESULTS: A 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.

CONCLUSION: Patients with OI may not experience higher rates of perioperative complications compared with patients without OI syndromes.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical autonomic research : official journal of the Clinical Autonomic Research Society
volume
31
issue
2
pages
231 - 237
publisher
Springer
external identifiers
  • pmid:32419101
  • scopus:85084845001
ISSN
1619-1560
DOI
10.1007/s10286-020-00697-y
language
English
LU publication?
yes
id
d349ccce-6b8d-42ee-9b96-c31bb5d6a56c
date added to LUP
2020-05-26 08:25:35
date last changed
2024-03-20 09:37:05
@article{d349ccce-6b8d-42ee-9b96-c31bb5d6a56c,
  abstract     = {{<p>INTRODUCTION: Orthostatic 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.</p><p>OBJECTIVES: To determine the rate of intra- and postoperative major adverse events in patients with OI undergoing surgery with general anesthesia.</p><p>METHODS: The study was a retrospective study of patients with orthostatic intolerance who underwent surgery requiring general anesthesia from 1 January 2000 to 31 December 2018.</p><p>RESULTS: A 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.</p><p>CONCLUSION: Patients with OI may not experience higher rates of perioperative complications compared with patients without OI syndromes.</p>}},
  author       = {{Ruzieh, Mohammed and Sacks, Cody D and Grewal, Simran S and Aboujamous, Nader M and Grubb, Blair P and Fedorowski, Artur}},
  issn         = {{1619-1560}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{231--237}},
  publisher    = {{Springer}},
  series       = {{Clinical autonomic research : official journal of the Clinical Autonomic Research Society}},
  title        = {{Risks of adverse events in patients with orthostatic intolerance undergoing surgery with general anesthesia}},
  url          = {{http://dx.doi.org/10.1007/s10286-020-00697-y}},
  doi          = {{10.1007/s10286-020-00697-y}},
  volume       = {{31}},
  year         = {{2021}},
}