November 29, 2025
Background: It remains unknown whether postoperative mean arterial pressures less than 65 mmHg constitute clinically important hypotension for individual patients, or might be within their normal pressure range.
Objective: We aimed to evaluate postoperative arterial pressure in patients recovering from noncardiac surgery and determine the proportion of patients in whom a mean arterial pressure less than 65 mmHg constitutes new-onset postoperative hypotension.
Design: A prospective observational study.
Setting: German university medical centre between October 2020 and September 2021.
Patients: Patients with elevated cardiovascular risk recovering on general wards from noncardiac surgery under general anaesthesia.
Main Outcome Measures: Before and after surgery, we automatically measured arterial pressure at 30-minute intervals for about 24 h. We considered patients to have new-onset postoperative hypotension when they had a postoperative mean arterial pressure less than 65 mmHg, and their lowest postoperative mean arterial pressure was at least 5 mmHg below their lowest preoperative mean arterial pressure.
Results: We enrolled 307 patients and included 248 in the final analysis. The median [IQR] duration of surgery was 62 [40 to 90] min. Postoperative mean arterial pressure was less than 65 mmHg at least once in 101 patients (41%). In 44 of these 101 patients (44%; 18% of all 248 patients), postoperative mean arterial pressures less than 65 mmHg constituted new-onset postoperative hypotension. In 57 of these 101 patients (56%; 23% of all 248 patients), postoperative mean arterial pressures less than 65 mmHg did not constitute new-onset postoperative hypotension.
Conclusion: About 40% of patients recovering from noncardiac surgery on general wards had at least one postoperative mean arterial pressure less than 65 mmHg, and about half of these patients had new-onset postoperative hypotension.
Published online: 11 July 2025
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