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Anesthesia

Abdominal Surgery and Long Term Effects

09/24/2008

Question:

I recently had major abdominal surgery, during which I lost 750 ml of blood and had a severe drop in blood pressure. I was kept sedated and was on a ventilator for three hours following surgery while I was given blood and fluids to raise the pressure. I don`t know how low it got during surgery (that wasn`t in the report) but I do know it got down to 53/37 in recovery. My question is, are there any long terms effects from this, and is there anything that can be done to avert this should I need more surgery in the future? I am a 45 year old woman.

Answer:

Really low blood pressure over a prolonged time can damage the vital organs - heart, brain, kidneys. A BP of 53/37 is really low. The amount of damage that might occur depends not only on the blood pressure but also on the amount of oxygen carried by the blood, the amount of hemoglobin available to carry that oxygen, and by the amount of blood pumped to the tissues. The effects therefore depend also on how much blood is still present in the body for the heart to pump. The body can sustain itself remarkably well when individuals are young, have healthy blood vessels, and healthy hearts to begin with, even when the blood pressure is very low for a long time.

There is no way for me to tell whether you will have long term effects from the episode you describe. The fact that you are writing this question suggests that your brain is fine and unless you have had serious underlying organic problems or blood vessel disease you may notice no long term effects at all. To avoid major blood loss during surgery there isn't much you as an individual can do. If blood loss is inevitable then you need a good surgical team, and as much physical "reserve" as possible - i.e. good lung function, lots of hemoglobin in your blood and a health heart and blood vessels. Obviously blood can be replaced by transfusion and preparations for this would be made ahead of time.

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Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University