Continuous intra-arterial versus noninvasive blood pressure monitoring for preventing hypotension during anesthesia induction in patients aged ≥ 75 years undergoing noncardiac surgery: a randomized controlled trial.
4 affiliations
- 1Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
- 2Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China. [email protected].
- 3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China. [email protected].
- 4Outcomes Research Consortium, Houston, TX, USA. [email protected].
Abstract
Background
Hypotension is common during the period after induction of general anesthesia and before surgical incision, particularly in older patients. The objective of this study was to compare the effectiveness of continuous intra-arterial pressure monitoring with that of noninvasive blood pressure monitoring in preventing hypotension during anesthesia induction in older patients (≥ 75 years) undergoing noncardiac surgery.Methods
In this single-center, randomized controlled trial, 82 older patients who were scheduled for elective noncardiac surgery under general anesthesia were randomly assigned to the continuous intra-arterial pressure monitoring group or the noninvasive blood pressure monitoring group. The primary outcome was the area under the curve for mean arterial pressure (MAP) < 65 mmHg during the first 15 min after induction, based on invasive blood pressure measurements.Results
The area under the curve for mean arterial pressure < 65 mmHg was significantly lower in the continuous intra-arterial pressure monitoring group (median (interquartile range), 0 (0-6.09) mmHg∙min) than in the noninvasive group (3.67 (0-26.45) mmHg∙min; P = 0.008). The continuous intra-arterial pressure monitoring group also had a shorter duration of MAP < 65 mmHg (0 (0-1.42) vs. 0.87 (0-3.88) minutes; P = 0.010), received lower doses of propofol (16.67 (13.34-24.15) vs. 30 (24.17-40.83) mg; P = 0.011) and remifentanil (25.34 (16.67-40.00) vs. 34.18 (25.00-57.00) µg; P = 0.045), and received vasoactive drugs earlier (0.87 (0.67-1.00) vs. 2.33 (1.87-3.33) minutes; P < 0.001) and at higher doses in the continuous intra-arterial pressure monitoring group.Conclusions
Compared with noninvasive blood pressure monitoring, continuous intra‑arterial pressure monitoring initiated before induction was associated with reduced the incidence, severity, and duration of hypotension during anesthesia induction in older patients (≥ 75 years) undergoing noncardiac surgery.Trial registration
This trial was registered in the Chinese Clinical Trial Registry (ChiCTR2400088505) on August 20, 2024 ( https://www.chictr.org.cn/ ).
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BibTeX
@article{li2026continuous,
title = {{Continuous intra-arterial versus noninvasive blood pressure monitoring for preventing hypotension during anesthesia induction in patients aged ≥ 75 years undergoing noncardiac surgery: a randomized controlled trial.}},
author = {Yihang Li and Shuang Liang and Yuqi Zhang and Ziyu Ye and Qulian Guo and Wangyuan Zou},
journal = {BMC anesthesiology},
year = {2026},
month = jul,
doi = {10.1186/s12871-026-04123-0},
url = {https://europepmc.org/article/MED/42894132},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Continuous intra-arterial versus noninvasive blood pressure monitoring for preventing hypotension during anesthesia induction in patients aged ≥ 75 years undergoing noncardiac surgery: a randomized controlled trial.
AU - Yihang Li
AU - Shuang Liang
AU - Yuqi Zhang
AU - Ziyu Ye
AU - Qulian Guo
AU - Wangyuan Zou
PY - 2026
DA - 2026/07/01
JO - BMC anesthesiology
DO - 10.1186/s12871-026-04123-0
UR - https://europepmc.org/article/MED/42894132
AB - Background Hypotension is common during the period after induction of general anesthesia and before surgical incision, particularly in older patients. The objective of this study was to compare the effectiveness of continuous intra-arterial pressure monitoring with that of noninvasive blood pressure monitoring in preventing hypotension during anesthesia induction in older patients (≥ 75 years) undergoing noncardiac surgery.Methods In this single-center, randomized controlled trial, 82 older patients who were scheduled for elective noncardiac surgery under general anesthesia were randomly assigned to the continuous intra-arterial pressure monitoring group or the noninvasive blood pressure monitoring group. The primary outcome was the area under the curve for mean arterial pressure (MAP) < 65 mmHg during the first 15 min after induction, based on invasive blood pressure measurements.Results The area under the curve for mean arterial pressure < 65 mmHg was significantly lower in the continuous intra-arterial pressure monitoring group (median (interquartile range), 0 (0-6.09) mmHg∙min) than in the noninvasive group (3.67 (0-26.45) mmHg∙min; P = 0.008). The continuous intra-arterial pressure monitoring group also had a shorter duration of MAP < 65 mmHg (0 (0-1.42) vs. 0.87 (0-3.88) minutes; P = 0.010), received lower doses of propofol (16.67 (13.34-24.15) vs. 30 (24.17-40.83) mg; P = 0.011) and remifentanil (25.34 (16.67-40.00) vs. 34.18 (25.00-57.00) µg; P = 0.045), and received vasoactive drugs earlier (0.87 (0.67-1.00) vs. 2.33 (1.87-3.33) minutes; P < 0.001) and at higher doses in the continuous intra-arterial pressure monitoring group.Conclusions Compared with noninvasive blood pressure monitoring, continuous intra‑arterial pressure monitoring initiated before induction was associated with reduced the incidence, severity, and duration of hypotension during anesthesia induction in older patients (≥ 75 years) undergoing noncardiac surgery.Trial registration This trial was registered in the Chinese Clinical Trial Registry (ChiCTR2400088505) on August 20, 2024 ( https://www.chictr.org.cn/ ).
SN - 1471-2253
ER -