緒言とまとめ

Up to Dating the Perioperative Blood Pressure Management：Preface and Comments

　術中術後の血圧管理は手術患者の予後を左右する可能性があるため，麻酔科医にとって重要な課題である。本特集は血圧の解説から始まり，術中血圧と術後臓器障害の関連，その周術期管理方法について，最近の知見や取り組みを紹介していただくことを目的とした。

　In this special issue of blood pressure monitoring, recent evidence regarding perioperative blood pressure management is summarized by experts in the field, covering a wide range of topics. The blood pressure monitoring and physiology of blood pressure are first described in detail, and the practical utility of ventricular-arterial coupling is explained. Perioperative myocardial infarction and myocardial injury after noncardiac surgery（MINS）are then reviewed, including their definitions and recent interpretation. The relationship between MINS and intraoperative blood pressure is also discussed. Acute kidney injury（AKI）and the importance of maintaining appropriate blood pressure values during surgery to avoid the development of AKI are described. Perioperative ischemic stroke and perioperative neurocognitive disorders（PNDs）are highlighted, and their associations with intraoperative blood pressure are presented. The efficacy of the administration of fluid versus vasoactive drugs to treat intraoperative hypotension is discussed based on organ protection. Notably, the recent clinical application of the hypotension prediction index（HPI）is explained in regard to preventing intraoperative hypotension. The issue’s last article describes strategies for preventing postoperative hypotension. In summary, this special issue focusing on perioperative blood pressure management will be an informative resource for every anesthesiologist who aims to provide safer anesthesia by preventing organ disorders after surgery.