Hypotension after surgery is common and is associated with patient harm including myocardial and kidney injury, stroke, delirium and death. The physiology of postoperative hypotension is poorly understood. Conventional models of the circulation posit that the sympathetic nervous system should compensate for any of the causes of hypotension and restore blood pressure, implicating dysfunction of the sympathetic nervous system in the development of postoperative hypotension.
There are a range of methods to assess sympathetic function, but few are appropriate for clinical practice in patients recovering from general anaesthesia. The isometric handgrip test for sympathetic dysfunction is a promising candidate test, but the feasibility of using this technique in surgical patients has not been established. We are conducting a pilot study aiming to evaluating the feasibility of using the isometric handgrip test to identify sympathetic dysfunction in patients having major surgery under general anaesthesia, in preparation for a large observational study to understand the influence of sympathetic dysfunction on postoperative hypotension.
Dr Ned Douglas, Associate Professor Jai Darvall, Professor Kate Leslie, Royal Melbourne Hospital and Department of Critical Care, University of Melbourne.
The project was awarded A$69,311 funding (including scholarship) through the ANZCA research grants program for 2025.