Penatalaksanaan Hipertensi Perioperatif

Oleh :

dr.Dizi Bellari Putri

Penatalaksanaan hipertensi perioperatif idealnya dimulai dengan evaluasi dan pencegahan hipertensi jauh hari sebelum operasi. Tujuan utama dari tata laksana adalah menurunkan tekanan darah dan risiko penyakit kardiovaskular. Terapi hipertensi perioperatif meliputi obat-obatan antihipertensi, antiplatelet, terapi suportif, dan modifikasi gaya hidup.[1,2,6,7]

Evaluasi Risiko dan Pencegahan Hipertensi Perioperatif

Pendekatan awal penatalaksanaan hipertensi perioperatif adalah penilaian risiko hipertensi dan gangguan kardiovaskular lainnya sebelum operasi. Pada pasien dengan riwayat hipertensi, terapi perlu diberikan untuk menurunkan tekanan darah dan mencegah risiko kardiovaskular lainnya.

Referensi

1. Gill R, Goldstein S. Evaluation and Management of Perioperative Hypertension. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK557830/
2. Tait A, Howell SJ. Preoperative hypertension: perioperative implications and management. BJA Educ. 2021 Nov;21(11):426-432. doi: 10.1016/j.bjae.2021.07.002. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520037/
3. Storozh V, et al. Postoperative Hypertension: When Blood Pressure Cuff and Arterial Line Disagree. Journal of Clinical Anesthesia and Pain Management, 2019. 3. 10.36959/377/327.
4. Lizano-Díez I, et al. The burden of perioperative hypertension/hypotension: A systematic review. PLOS ONE, 2022. 17(2): e0263737. https://doi.org/10.1371/journal.pone.0263737
6. Halvorsen S, Mehilli J, Cassese S, et al. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery: Developed by the task force for cardiovascular assessment and management of patients undergoing non-cardiac surgery of the European Society of Cardiology (ESC) Endorsed by the European Society of Anaesthesiology and Intensive Care (ESAIC). European Heart Journal, 2022. Volume 43, Issue 39, Pages 3826–3924, https://doi.org/10.1093/eurheartj/ehac270
7. KEMENKES RI. Pedoman Nasional Pelayanan Kedokteran (PNPK) Tata Laksana Hipertensi Dewasa. 2021. https://www.kemkes.go.id/eng/pnpk-2021---tata-laksana-hipertensi-dewasa
9. Bergholz A, et al. Effect of personalized perioperative blood pressure management on postoperative complications and mortality in high-risk patients having major abdominal surgery: protocol for a multicenter randomized trial (IMPROVE-multi). Trials, 2022. 23, 946. https://doi.org/10.1186/s13063-022-06854-0
10. Calderón M, et al. Perioperative hypertension. Colombian Journal of Anesthesiology. 2023. 51. 10.5554/22562087.e1066.
17. Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, Ramirez A, Schlaich M, Stergiou GS, Tomaszewski M, Wainford RD, Williams B, Schutte AE. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1334-1357. doi: 10.1161/HYPERTENSIONAHA.120.15026.
20. Stenglova A, Benes J. Continuous Non-Invasive Arterial Pressure Assessment during Surgery to Improve Outcome. Front Med (Lausanne). 2017 Nov 17;4:202. doi: 10.3389/fmed.2017.00202.
21. Marcucci M, et al; POISE-3 Trial Investigators and Study Groups. Hypotension-Avoidance Versus Hypertension-Avoidance Strategies in Noncardiac Surgery : An International Randomized Controlled Trial. Ann Intern Med. 2023; 176(5):605-614. doi: 10.7326/M22-3157. https://www.researchgate.net/publication/370253291_Hypotension-Avoidance_Versus_Hypertension-Avoidance_Strategies_in_Noncardiac_Surgery_An_International_Randomized_Controlled_Trial
22. Khalil H, Zeltser R. Antihypertensive Medications. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK554579/

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