MANAJEMEN PERIOPERATIF PADA HIPERTENSI

Abstract

Hypertension is a leading cause of death and the most frequent preoperative abnormality in surgical patients, and become
major risk factor for cardiac, cerebral, renal and vascular disease during intraoperative or post-operative periode. Agressive
controlled hypertension will decrease complications due to the damage of end organs. Consequences by taking anti-hypertensive
agents is the interaction with other medications that being used during surgery. Consideration must be taken especially due to the
half life and adjustment dose of this medications. The National Committee 7 (JNC 7) on prevention, detection, evaluation and
treatment of high blood pressure 2003, degree of hypertension can be classified into pre-hypertension (120-139/80-89), hypertension
stage 1 (140-159/90-99 mmHg) and hypertension stage 2 (systolic pressure 160 mmHg or diastolic pressure 100 mmHg).
According to the etiology, hypertension can be classified into primary hypertension (80-95%) and secondary hypertension (10-
15%) due to the causes. Usually hypertension always has association with abnormality of sympathetic activity, increasing the
pheripheral vascular resistance (SVR) or increasing both of them. But the most common cause of hypertension is increasing the
pheripheral vascular resistance. Management perioperative of hypertension includes evaluation and optimalised patients condition
preoperative, management patients who under influenced of anesthetic agents and treatment post operative. Patient with
hypertension incline to have instability haemodinamic and more sensitive to anesthesia and surgery procedures, so carefull must
be taken at the beginning of anesthesia and surgery until post operatively, especially to control hemodynamic. The best monitoring
for patient with hypertension is by using suitable anesthetic techniques, anesthetic agents and antihypertensive agents. Post
operative hypertension can be happened due to several factors such as, inadequate antihypertensive agents, respiratory disturbance,
pain, fluid overload, or distended of the bladder. Excellent perioperative management of hypertension patients before
surgery will decrease morbidity and mortality rate