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Comparison between Invasive and Non-Invasive Blood Pressure Monitoring in High-Risk Prolonged Surgeries in a Medical College of Assam

BACKGROUND Blood pressure monitoring in intraoperative period is one of the basic parameters in haemodynamic monitoring. This guides an anaesthesiologist to maintain an optimal condition between the patient’s stress condition and the depth of anaesthesia. Blood pressure can be measured either invasively or non-invasively in patients undergoing surgery. Invasive measurement from an arterial line is the preferred method even though there may be calibration errors, movement artefacts and over or under damping. The gold standard in cases of high-risk prolonged surgery is continuous monitoring of blood pressure by means of invasive blood pressure (IBP) measurement. The purpose of this study was to compare the non-invasive and invasive blood pressure monitoring in patients undergoing high risk surgeries METHODS After getting institutional ethical committee (H) clearance, study was conducted on 40 patients undergoing high-risk prolonged surgeries. Non-invasive blood pressures (NIBP) were recorded by oscillometric method before intubation, after intubation, half an hour after intubation and one hour after intubation. Simultaneously invasive blood pressure monitoring was done by establishing radial artery line. Bland-Altman plot was used to compare the blood pressure measurement by the non-invasive and invasive method. RESULTS Systolic blood pressure readings using non-invasive blood pressure monitoring was overestimated, diastolic and mean arterial pressure (MAP) readings using noninvasive blood pressure monitoring was underestimated in all instances. In all time points non-invasive blood pressure showed a good correlation with invasive blood pressure. CONCLUSIONS The study revealed that there is statistically significant difference between noninvasive and invasive blood pressure readings. We recommend invasive blood pressure monitoring in high-risk surgeries and critically ill patients, although a large-scale study is required to arrive at a conclusion. KEYWORDS Non-invasive Blood Pressure, Invasive Blood Pressure, Bland-Altman Analysis, High Risk Surgery