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Abstract Postoperative hypertension is a pathophysiological state that requires rapid assessment and appropriate treatment. It is an acute transient increase in blood pressure that develops within 30-90 min following surgical procedure and lasts 4-8 hours. SBP > 190 mmHg or DBP > 100 mm Hg or an increase of 40-50 mm Hg in systolic blood pressure or post-operative BP greater than 15-20% above baseline. A number of overlapping pathophysiologic mechanisms are responsible for the development of postoperative hypertension, including activation of the sympathetic nervous and reninangiotensin systems, as evidenced by elevated plasma catecholamine concentrations in these patients. There are factors Contributing to development of postoperative hypertension as pain, excitement on emergence, hypercarbia, hypoxia, hypervolemia, bladder distension, poor preoperative BP control, acute alcohol or cocaine intoxication, malignant hypertension, severe, head trauma, pheochromocytoma, encephalopathy, thyroid storm, abrupt beta blocker withdrawal. Types of surgery can also influence the likelihood of post-op hypertension as vascular, cardiac, neck, endocrine. Uncontrolled postoperative hypertension is an independent predictor of morbidity and mortality, more unplanned ICU admissions and greater mortality. If left untreated, will depress LV performance, increased myocardial O2 demand, cerebrovascular accidents, acute MI, arrhythmias, suture line disruption and bleeding. |