Intraoperative Hemodynamic Profile: Evaluation of Mean Arterial Pressure in Patients Undergoing General Anesthesia

Suyanti Suyanti; Yuli Widyastuti; Indah Nur Aisyah

doi:10.56359/gj.v7i1.958

Authors

Suyanti Universitas Muhammadiyah PKU Surakarta
Yuli Widyastuti Universitas Muhammadiyah PKU Surakarta
Indah Nur Aisyah Universitas Muhammadiyah PKU Surakarta

DOI:

https://doi.org/10.56359/gj.v7i1.958

Keywords:

general anesthesia, hemodynamic monitoring, intraoperative hypotension

Abstract

Introduction: Intraoperative hemodynamic fluctuations during general anesthesia are clinically important because reduced Mean Arterial Pressure (MAP) may compromise organ perfusion and contribute to postoperative complications. Despite growing awareness of the need for hemodynamic control, variations in MAP across different patient characteristics and surgical types remain insufficiently documented in clinical practice.

Objective: This study aimed to evaluate intraoperative MAP patterns in patients undergoing general anesthesia and to identify variations based on demographic and clinical factors.

Method: A descriptive observational design was applied to 61 elective surgical patients with ASA physical status I–II at RSI Sultan Agung Semarang. Intraoperative MAP measurements were recorded using standardized patient monitoring systems. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation.

Result: The mean intraoperative MAP was 69.49 ± 4.32 mmHg. Although most respondents maintained normotensive values, 8.2% experienced hypotension below the 65 mmHg threshold. Higher MAP values were observed in patients aged 41–50 years, those with ASA II status, and those undergoing lower abdominal surgery. Lower MAP values were more common in urology procedures and among ASA I patients.

Conclusion: Although the overall MAP level remained within the acceptable clinical range, the presence of intraoperative hypotension in a subset of patients underscores the importance of proactive, individualized hemodynamic monitoring. Variations in MAP across demographic and surgical factors highlight the need for patient-specific hemodynamic targets to ensure optimal intraoperative safety.

Downloads

Download data is not yet available.

References

Abbott, T. E., et al. (2025). Impact of hypotension prediction index-guided management on intraoperative hypotension and postoperative outcomes in abdominal surgery: A meta-analysis. PubMed, 41175934.

Arlyana, H., et al. (2024). A descriptive study of intra-anesthesia hemodynamic status in patients with spinal anesthesia. Neliti/Morowali Hospital, 177–185.

Barash, P. G., Cullen, B. F., Stoelting, R. K., Cahalan, M. K., Stock, M. C., & Ortega, R. (2017). Clinical anesthesia (8th ed.). Wolters Kluwer.

Brown, A., et al. (2024). Assessment of haemodynamic response to induction of general anaesthesia in healthy adult patients. Open Anesthesia Journal, 11, 75–82.

Butterworth, J. F., Mackey, D. C., & Wasnick, J. D. (2022). Morgan & Mikhail’s clinical anesthesiology (7th ed.). McGraw Hill.

Daabiss, M. (2011). American Society of Anaesthesiologists physical status classification. Indian Journal of Anaesthesia, 55(2), 111–115.

Gropper, M. A., Cohen, N. H., Eriksson, L. I., Fleisher, L. A., Leslie, K., & Wiener-Kronish, J. P. (2019). Miller’s anesthesia (9th ed.). Elsevier.

Kabnani, M. W., et al. (2025). Overview of hemodynamic status in patients under spinal anesthesia. Journal of Midwifery and Nursing, 7(1), 169–175.

Kouz, K., et al. (2025). Haemodynamic monitoring and management during non-cardiac surgery: A survey among German anaesthetists. Journal of Clinical Monitoring and Computing, 39, 853–861.

Lestari, D., et al. (2025). Analysis of factors contributing to low bed occupancy rate in inpatient wards. Genius Journal, 6(2), 494–499.

Ma, H., et al. (2024). Intraoperative hypotension prediction in cardiac and noncardiac procedures: Is HPI truly worthwhile? A systematic review. PubMed, 40745629.

Miller, T. E., et al. (2025). Guideline for the management of critical bleeding and hemodynamic support. Journal of Anesthesia.

Pratiwi, A., et al. (2025). Factors associated with the incidence of breast cancer in hospitalized patients. Genius Journal, 6(2), 330–336.

Purwati, A. E., et al. (2025). Factors associated with incomplete electronic medical records by nurses after the transition from manual documentation. Genius Journal, 6(2), 337–345.

Putu, I., et al. (2022). The effect of intravenous induction of anesthesia on the hemodynamic changes among patient in central surgical unit. Babali Nursing Research, 3(3), 111–120.

Salmasi, V., Maheshwari, K., Yang, D., Mascha, E. J., Singh, A., Sessler, D. I., & Kurz, A. (2017). Relationship between intraoperative hypotension, defined by either reduction from baseline or absolute thresholds, and acute kidney and myocardial injury. Anesthesiology, 126(1), 47–65.

Sari, I., et al. (2025). Relationship between depression, anxiety levels, and coping mechanisms in patients with congestive heart failure. Genius Journal, 6(2), 323–329.

Saugel, B., & Vincent, J. L. (2018). Hemodynamic monitoring in the elderly. Current Opinion in Critical Care, 24(4), 289–294.

Saugel, B., et al. (2025). Current practices in hemodynamic monitoring and management during non-cardiac surgery in Austria. PubMed Central, 12455795.

Sessler, D. I., & Bloomstone, J. A. (2019). Perioperative Quality Initiative consensus statement on intraoperative blood pressure, risk and outcomes for elective surgery. British Journal of Anaesthesia, 122(5), 563–574.

Sessler, D. I., & Khanna, A. K. (2025). Intraoperative hypotension and major adverse cardiac events among older adult patients: A retrospective cohort study. NIH/PMC, 12530642.

Sijunjung, R. (2024). Description of hemodynamic changes in sectio caesarea patients with spinal anesthesia. Java Nursing Journal, 38–45.

Smith, J. R., et al. (2025). Optimization of the target strategy of perioperative infusion therapy based on monitoring data. Frontiers in Medicine, 935331.

Solihah, R., & Purwati, A. E. (2023). The effect of E-FAS on the knowledge of post-partum. Genius Journal, 4(2).

Suyanti, Widyastuti, Y., & Aisyah, I. N. (2025). Intraoperative hemodynamic profile: Evaluation of mean arterial pressure (MAP) in patients undergoing general anesthesia. Genius Journal, 6(1), 348–354.

Tan, C., et al. (2025). Remimazolam and propofol for hemodynamic stability in hypertensive patients. Journal of Anesthesia.

Weiser, T. G., Haynes, A. B., Molina, G., Lipsitz, S. R., Esquivel, M. M., Uribe-Leitz, T., ... & Gawande, A. A. (2015). Estimate of the global volume of surgery in 2012: An assessment supporting improved health outcomes. The Lancet, 385(Suppl 2), S11.

Wijnberge, M., et al. (2025). The hypotension prediction index versus mean arterial pressure in predicting intraoperative hypotension: A clinical perspective. PMC, 12052080.

Zhang, L., et al. (2025). Associations of intraoperative hypotension and perioperative blood pressure with delirium after noncardiac surgery. PubMed, 40384076.