Preoperative haemodynamic measurements compared to haemodynamic response of tracheal intubation. Search for the most appropriate baseline

Objective: To measure the variability in blood pressure and heart rate in the pre operative clinic, after admission in the ward, in the holding area of the operating room, and inside the operating room. Our secondary objective was to see which blood pressure and heart rate should be taken as a baseline for clinical monitoring during anaesthesia especially when one is looking at haemodynamic changes associated with tracheal intubation. Methods: Thirty consecutive patients meeting the study inclusion criteria were enrolled at the preoperative anaesthesia clinic. Non invasive blood pressures and heart rate were measured at the pre operative anaesthesia clinic, in the ward, in the holding area on morning of surgery, and inside the operating room. Results: The difference between the haemodynamic readings at different locations was not statistically significant for heart rate and diastolic blood pressure however they were statistically significant for systolic and mean arterial pressures with highest pressures recorded in the immediate pre induction period. The change to maximum reading was 17.18% , 11.89% ,7.83% , 3.59% when clinic, ward, holding area or operating room were taken as baseline alternatively . Conclusion: Variability exists in the measurement of systolic blood pressure taken at different hospital locations in surgical patients. Further work needs to be done to define the appropriate baseline for haemodynamic monitoring and research.