Utpal Dutta1, Mahin Aboobacker B.2, Rituparna Bora3
BACKGROUND
Blood pressure monitoring in intraoperative period is one of the basic parameters
in haemodynamic monitoring. This guides an anaesthesiologist to maintain an
optimal condition between the patient’s stress condition and the depth of
anaesthesia. Blood pressure can be measured either invasively or non-invasively
in patients undergoing surgery. Invasive measurement from an arterial line is the
preferred method even though there may be calibration errors, movement
artefacts and over or under damping. The gold standard in cases of high-risk
prolonged surgery is continuous monitoring of blood pressure by means of invasive
blood pressure (IBP) measurement. The purpose of this study was to compare the
non-invasive and invasive blood pressure monitoring in patients undergoing high
risk surgeries
METHODS
After getting institutional ethical committee (H) clearance, study was conducted
on 40 patients undergoing high-risk prolonged surgeries. Non-invasive blood
pressures (NIBP) were recorded by oscillometric method before intubation, after
intubation, half an hour after intubation and one hour after intubation.
Simultaneously invasive blood pressure monitoring was done by establishing radial
artery line. Bland-Altman plot was used to compare the blood pressure
measurement by the non-invasive and invasive method.
RESULTS
Systolic blood pressure readings using non-invasive blood pressure monitoring was
overestimated, diastolic and mean arterial pressure (MAP) readings using noninvasive
blood pressure monitoring was underestimated in all instances. In all time
points non-invasive blood pressure showed a good correlation with invasive blood
pressure.
CONCLUSIONS
The study revealed that there is statistically significant difference between noninvasive
and invasive blood pressure readings. We recommend invasive blood
pressure monitoring in high-risk surgeries and critically ill patients, although a
large-scale study is required to arrive at a conclusion.
