Audit of Intraoperative Hypertension Management in 75 Patients at THQ Hospital Sadiq Abad

Background Intraoperative hypertension (IOH) is a frequent anesthetic challenge linked to myocardial ischemia, arrhythmias, cerebrovascular events, and increased surgical bleeding. Despite its impact, structured evaluation of IOH management is inconsistent, especially in resource-limited hospitals.

To evaluate recognition, documentation, precipitating causes, and management of IOH at THQ Hospital Sadiq Abad, and to identify gaps relative to accepted standards.

A retrospective audit of 75 adult patients (18–75 years) with documented IOH episodes from January to June 2025 was conducted. Data extracted from anesthesia records included demographics, ASA grade, type of surgery, anesthetic technique, recorded trigger(s), interventions, and immediate outcomes. Audit standards were adapted from the Association of Anaesthetists’ peri-operative hypertension guidance. Descriptive statistics were used to summarize findings and guide recommendations.

IOH was documented in all 75 cases (100%). A precipitating cause was recorded in 52%. The most common first-line response was deepening anesthesia (42%), followed by opioid boluses (28%) and antihypertensives (16%). Targeted correction of reversible triggers (e.g., bladder decompression, ventilatory adjustment) was documented in 14%. No peri-operative mortality occurred; however, prolonged IOH (>15 minutes) was noted in a minority of cases.

While recognition of IOH was universal, documentation of triggers and targeted, protocolized management were suboptimal. Introducing a structured proforma, theatre-posted algorithms, and focused teaching—followed by re- audit in 6–12 months—may improve patient safety. Competing Interest Statement The authors have declared no competing interest. Funding Statement Managed by myself Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Hospital Ethical Review/Audit Committee of THQ Hospital Sadiq Abad confirms that this audit was carried out as part of the hospital's routine quality improvement and patient safety program. No identifiable patient data were collected or disclosed and complete confidentiality was maintained throughout. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability Data available upon reasonable request