Low blood pressure after surgery is an important problem because it can cause damage to organs such as the heart, kidneys and brain. There are a wide variety of ways to treat low blood pressure, but which one will work is determined by what the cause of the low blood pressure might be.
One of the contributors to low blood pressure might be a condition called sympathetic autonomic dysfunction, where the part of the nervous system responsible for controlling blood pressure is dysfunctional. Identifying this condition without specialised testing is difficult however, and a number of the ways of testing for it are not suitable for use after surgery. However, one way known as the isometric handgrip test may be feasible to use, but there is no data to tell us whether it would be useful.
The project aimed to determine if it was feasible to use the isometric handgrip test to screen for sympathetic autonomic dysfunction in the post anaesthetic care unit.
Royal Melbourne Hospital and Department of Critical Care, University of Melbourne
Dr Ned Douglas, Associate Professor Jai Darvall and Professor Kate Leslie
The project was awarded A$69,311 funding (including scholarship) through the ANZCA research grants program for 2025.
The majority of patients completed the isometric handgrip test in PACU without problems. However, the results suggested that it would not be a useful screening test because it screened positive much more frequently that was expected. It may be necessary to test against other measures of sympathetic autonomic dysfunction to adequately calibrate the test in surgical patients.
The results suggest that further evaluation of the isometric handgrip test is required to see if it would be useful in clinical practice. An alternative test may prove to be more suitable.
The study is currently being considered for publication in Anaesthesia and Intensive Care.
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