Hemodynamic profile associated with the induction of general anesthesia

Abstract

Background. General anesthetics have significant effects on the hemodynamic profile of the patient, depending on comorbidities and the associated anesthetic risk. Continuous intraoperative monitoring of hemodynamic parameters allows for early identification of these effects and prompt subsequent intervention. Objective(s). To evaluate the hemodynamic profile of patients undergoing general anesthesia based on ASA score, age and comorbidities (arterial hypertension, obesity degree, diabetes mellitus). Materials and methods. A prospective study was conducted on 60 patients undergoing general anesthesia during laparoscopic cholecystectomy, in the IMU, between January and June 2025. The analyzed hemodynamic parameters were: BP, HR, perfusion index, during preinduction, induction and the following 20 min, using the Mann-Whitney U and KruskalWallis tests. Results. Statistically significant differences were found in the ASA I, II, III groups in induction sBP- 123.82 vs 138.69 vs 169.21 (p<0.001), induction dBP- 74.73 vs 82.89 vs 93.64 (p=0.011), induction MAP- 90.36 vs 102.34 vs 119.36 (p=0.004), induction PI- 5.51 vs 2.69 vs 2.17 (p=0.011). In the age groups > 55 and > 65 years, differences were noted in sBP, dBP, MAP at induction (p<0.05). In class I obesity, there were differences in sBP (p<0.044), dBP (p<0.016), MAP (p=0.05) at 5th min, and in class III - in sBP (p=0.032), MAP (p=0.025) at 3rd min. In hypertension, variations were noted in sBP, dBP, MAP at induction, in 1st and 2nd min (p<0.05). Conclusion(s). The ASA score, the age and the comorbidities (obesity, hypertension) cause variations in hemodynamic indices during induction of general anesthesia, which allows early stratification of patients for appropriate pre-anesthetic preparation and according to the protocol-intraoperative management.