Intraoperative hypotension and hypertension can lead to end-organ injury, worsen clinical outcomes, and increase health care costs (Br J Anaesth 2018;121:706-21; Anesth Analg 2002;95:273-7; Anesthesiology 2018;128:317-27; J Hypertens 2021;39:1982-90; Anesthesiology 2011;114:1289-96; J Neurosurg 2017;127:1025-40; J Patient Saf 2021;17:e758-e64; J Clin Anesth 2021;75:110516). Unfortunately, there is little consensus on whether optimal blood pressure represents a target range or is customized to the patient's baseline. Anesthesiologists play a vital role in optimizing intraoperative perfusion pressure and improving outcomes; however, more work remains to be done to determine the optimal targets for intraoperative blood pressure.
Sustained intraoperative hypotension is associated with end-organ injury. Postoperative acute kidney injury (AKI), for example, is a common complication in major noncardiac surgery. The incidence of AKI has been reported to be as high as 12% in certain surgical populations and has been repeatedly associated with increased long-term morbidity,...
