17/09/2026
Postoperative hypotension after noncardiac surgery is frequent: 73,3% below 75mmHg, 37,7% below 65mmHg
A prospective, blinded observational study at University Medical Center Hamburg-Eppendorf. In 1,002 patients, blood pressure was measured hourly by automated oscillometry over the first 3 postoperative days.
37.7% of patients had at least one postoperative episode of MAP < 65 mmHg, with a median cumulative duration of 180 minutes, or 7.1% of their monitoring time. Severe hypotension (MAP < 55 mmHg) occurred in 9.1% of patients and briefly (60-120 min). Readings below 75 mmHg, by contrast, were frequent (73.3% of patients) and often prolonged (182-1052 min). Incidence fell from 30% of participants on postoperative day 1 to 17% on day 3.
Exploratory findings: compared to patients without hypotension, patients with postoperative hypotension had higher rates of acute kidney injury (10.5% vs. 7.4%) and unplanned ICU admission (4.0% vs. 1.3%). Overall complication rates according to Clavien-Dindo classification did not differ between patients with and without postoperative hypotensive events (28.3% vs. 27.1%).
The authors conclude that postoperative hypotension within the first 3 postoperative days is common but rarely severe or prolonged, and that large-scale trials are still needed to show whether continuous postoperative monitoring and targeted blood pressure management can help improve patient-centred outcomes.
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Reference:
Flick M, Stemmler S, Bossemeyer M, Überleer B, Hoppe P, Bünsch M, Krause L, Thomsen KK, Saugel B. Postoperative hypotension in patients recovering from noncardiac surgery: a prospective, blinded observational study. Br J Anaesth. 2026 Jul;137(1):66-73. doi: 10.1016/j.bja.2026.04.042. Epub 2026 Jun 1. PMID: 42225440; PMCID: PMC13494075; https://pubmed.ncbi.nlm.nih.gov/42225440/
