Intraoperative and postoperative characteristics.

ObjectivePostoperative delirium is a common complication after neurosurgery. The association between intraoperative hypotension and postoperative delirium in the neurosurgical population is unknown.DesignThis is a secondary analysis of a randomized controlled studySettingAdults scheduled for elective craniotomy under general anesthesia were included in 1 study center.ParticipantsOf 260 patients, a total of 240 participants are included for final analysis after excluding patients without intraoperative blood pressure data.The primary outcome measuresThe primary outcome was the occurrence of delirium within the first 5 postoperative days, assessed with the Confusion Assessment Method or a 3-minute Diagnostic interview for the Confusion Assessment Method.ResultsA total of 240 patients were included (median age, 45 years), and 83(35%) patients experienced postoperative delirium. Curves of lowest mean arterial pressure versus stroke incidence suggested a threshold at 65 mmHg. There was no association between duration below 65 mm Hg and postoperative delirium (odds ratio, 1.01; 95% confidence interval, 0.96, 1.06). The odds ratio for duration below 65 mm Hg for 10 minutes was 1.03 (95% confidence interval, 0.97, 1.09) adjusted by history of hypertension, age > 45 yr, tumor volume, tumor type of glioma, preoperative Mini-Mental State Examination (MMSE) >26, and dexmedetomidine infusion which were all indicated the independent risk factors for delirium.ConclusionsThe current results could not indicate intraoperative hypotension of mean arterial pressure lower than 65 mmHg associated with delirium after frontotemporal brain tumor resection.Trial registrationClinicalTrials.gov NCT04674241