Resumen

Objectives: The authors evaluated the association of elevated or labile intraoperative systolic blood pressure (SBP) with postoperative hematoma, based on the senior author’s single surgeon experience of 118 consecutive facelifts. Introduction: Although there exists ample evidence on the impact of perioperative blood pressure on hematoma incidence following facelift, the association of elevated or labile intraoperative blood pressure with postoperative hematoma remains to be explored. Materials / method: Complete demographic, procedure-related, blood pressure–related, and outcomes- related data, with the outcome of interest representing postoperative hematoma was evaluated. One-way ANOVA and linear regression analyses were performed to assess for significant associations between a preoperative history of hypertension and a tendency to demonstrate elevated or labile intraoperative SBP. A Fisher’s exact test was subsequently applied to assess for specific intraoperative SBP measurement cutoffs significantly associated with postoperative hematoma. Results: Labile intraop SBP & high immediate postop SBP (P = .002) were both independent and statistically significant predictors of postoperative hematoma. Patients with a preoperative history of hypertension, and more specifically those with elevated SBP measurements in the preoperative clinic, were more likely to demonstrate labile (P = .007) or elevated (P = .005) intraoperative SBP during facelift surgery. Specifically, maximum recorded intraoperative SBP ≥155 mmHg (P = .045) and maximum intraoperative SBP fluctuations ≥80 mmHg (P = .036) were found to be significantly associated with hematoma. Conclusion: In contrast to hypertension that is aggressively treated and successfully controlled, hypertension that is difficult to control intraoperatively may be a predictor of systolic blood pressure that is difficult to control postoperatively, and therefore a significant risk factor for postoperative hematoma following facelift.