Comparison of Midazolam and Dexmedetomidine for sedation in Postoperative intubated patients of head and neck surgery on spontaneous ventilation in Intensive care unit

2021 ◽  
pp. 2557-2562
Author(s):  
Ashok Chaudhari ◽  
Amol Singam ◽  
Ayushma Jejani
Keyword(s):  
Blood Pressure ◽  
Neck Surgery ◽  
Sedation Score ◽  
Spontaneous Ventilation ◽  
Loading Dose ◽  
Midazolam Group ◽  
Group D ◽  
Ramsay Sedation Score ◽  
Oromaxillofacial Surgery

Introduction: Sedation is important in the care of the critically ill and postoperative patients. Amount of drug and duration for which it is given, is important in determining patient outcome. Aim: Study aimed to compare the safety and efficacy of injection midazolam and injection dexmedetomidine for sedation in postoperative patients of oromaxillofacial surgery with endotracheal tube in-situ, on spontaneous ventilation in ICU. Methodology: This prospective, randomized, comparative study was conducted on 60 patients undergoing oromaxillofacial surgery who were randomized in two groups of 30 patients each. Group D received injection demedetomidine loading dose of 1μg/kg over 15 minutes, followed by infusion at the rate of 0.2-0.7µg/kg/hr (microgram/kilogram/hour) and Group M received injection midazolam loading dose of 0.05mg/kg over 15 minutes followed by maintenance infusion at the rate of 0.02-0.06mg/kg/hr (milligram/kilogram/hour). The monitored indices included heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, SpO2 and Ramsay sedation score at the start of sedation when the Ramsay sedation score (RSS) was I and time to extubation after stopping sedation. Results: Target sedation range was achieved in a mean duration of 10.36 ± 3.05 minutes in dexmedetomidine group and that in midazolam group was 7.43±2.06 minutes. Highest value of RSS score in dexmedetomidine group was 2.43±0.50, which was observed at the 4th and 10th hour whereas in midazolam group it was 2.83±0.38 which was observed at 6th hour of the study period. Total dose of rescue analgesic required was more in midazolam group as compared to the dexmedetomidine group. The mean duration of extubation after cessation of sedation was 33.27±11.37 minutes in dexmedetomidine group and 49.43±5.58 minutes in midazolam group. Conclusion: Injection dexmedetomidine is better as compared to injection midazolam for postoperative sedation.

scholarly journals The Efficacy and Safety of Nabufen and Sufentanil in the Prevention of Visceral Pain After Gynecological Laparoscopic Surgery: A Randomised Controlled Trial

2020 ◽  
Author(s):  
Xiaoxia Gu ◽  
Jingjing Wang ◽  
Huihua Liao ◽  
Jian Mo ◽  
Weiming Huang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Adverse Reactions ◽  
Visceral Pain ◽  
Sedation Score ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D ◽  
Ramsay Sedation Score

Abstract Background: To compare the efficacy and safety of different compatibility schemes in the prevention of visceral pain after gynecological laparoscopic surgery. Methods: from April 2019 to April 2020, patients undergoing elective gynecological laparoscopic surgery in our hospital were randomly divided into four groups: group A: sufentanil 3 μ g / kg; group B: low-dose nalbuphine group: 0.1 mg / kg of nabufen + 3 μ g / kg of sufentanil; group C: medium dose of nabufen group: 1 mg / kg of nabufen + 2 μ g / kg of sufentanil; group D: high-dose nabufen 2 There were 30 cases in each group. The degree of pain and the number of adverse reactions at 2, 4, 8, 12, 24 and 48 hours after operation were observed and recorded. The number and dosage of morphine used as a remedial analgesic were recorded. The pain degree was assessed by visual analogue scale (VAS). The total amount of analgesic pump used, the total number of times of pressing and the effective times of pressing were recorded. The adverse reactions included respiratory depression, nausea and vomiting, drowsiness, restlessness and skin The skin itches. Results: the analgesic effect of group B was similar to that of group A, and there was no significant difference in the number of invalid pressing, total pressing times and rescue analgesia rate (P > 0.05), while the invalid pressing times, total pressing times and remedial analgesia rate of group C and group D were significantly lower than those of group A (P < 0.05). There was no significant difference between group C and group D in the number of invalid compressions, the total number of compressions and the rate of remedial analgesia (P > 0.05), suggesting that increasing the dose of nalbuphine could not significantly increase the analgesic effect. The incidence of postoperative nausea and vomiting, skin pruritus, lethargy and Ramsay Sedation score in group B and group C were significantly lower than those in group A (P < 0.05). Ramsay Sedation score and incidence of drowsiness were lower than those in group D, which indicated that the incidence of adverse reactions was higher in group D than group B and group C.Conclusion: the combination of 1 mg / kg nabufen and 2 μ g / kg sufentanil is a safe and effective combination scheme for the prevention of visceral pain after gynecological laparoscopic surgery with small adverse reactions.Trial registration: http://www.chictr.org.cn/showproj.aspx?proj=40635Registration number：ChiCTR1900025076 . Prospectively registered on 10 August 2019.

scholarly journals CONSCIOUS SEDATION FOR MIDDLE EAR SURGERIES: COMPARISON BETWEEN PROPOFOLAND MIDAZOLAM WITH RESPECT TO HEMODYNAMIC EFFECTS

2020 ◽  
pp. 1-4
Author(s):  
Firdos Girkar ◽  
Priyanka Jagavkar
Keyword(s):  
Blood Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Diastolic Blood Pressure ◽  
Middle Ear ◽  
Conscious Sedation ◽  
Sedation Score ◽  
Arterial Oxygen ◽  
Midazolam Group ◽  
The Difference

Background and aims: Middle ear surgeries can be done under local anesthetic infiltration and titrated dose of sedation. Use of supplemental intravenous sedative hypnotic drugs for these surgeries under local anesthesia can enhance patient comfort and increase acceptance of this technique. Our study was aimed to compare Propofol and Midazolam in equipotent doses for conscious sedation in middle ear surgeries Methods and material: After approval from the Institutional Ethics committee, 60 patients from ASA grade 1 and 2 scheduled for middle ear surgery (Tympanoplasty, mastoidectomy) under local anesthesia were randomly allocated into two groups to receive either Propofol (Group I) or Midazolam (Group II) for conscious sedation. Both the groups received premedication and sedation with 1.5 mcg /kg Fentanyl, Group 1 received Inj. Propofol bolus dose of 0.5-1 mg/Kg I.V, followed by infusion at the rate of 1.5-4.5 mg/kg/hour, to attain a sedation score of 3 and additional bolus doses were given as and when required to maintain a sedation score of 3. Group 2 received Inj. Midazolam bolus dose 0.03 to 0.05 mg/kg I.V followed by infusion at the rate of 0.03 to 0.06 mg/kg/hour to attain a sedation score of 3 and additional bolus doses as and when required to maintain a sedation score of 3. All the patients in both the groups received oxygen by nasal prongs at the flow rate of 4L/min from the start of sedation. Heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, oxygen saturation was noted at basal level and at an interval of 2 minutes and later every 5 mins for 30 mins then every 15 mins till end of surgery. Result: The results were analyzed using student’s 't’ test and chi square test wherever appropriate. Results: Pulse rate at 30th minute of sedation was not significantly different from the basal value among both the groups. Mean systolic blood pressure (SBP) in Propofol group was 121.33mmHg and 117.27mmHg among Midazolam group at basal which was comparable and the difference was not significant. Mean diastolic blood pressure was 78.47mmHg in Propofol group and 78.07mmHg among Midazolam group at basal which was comparable and the difference was not significant. Mean respiratory rate (breaths/min) among Propofol and Midazolam group were 16.83 and 16.70 respectively at basal which was comparable and the difference was not significant. Mean arterial oxygen saturation (%) among Propofol and Midazolam group were and 98.0 and 98.07 respectively at basal which was comparable and the difference was not significant. Conclusions: After the start of sedation mean diastolic blood pressure did not show any significant change in both the groups throughout the procedure. After the start of sedation mean respiratory rate and arterial oxygen saturation did not show any significant change in both the groups. Both Propofol and Midazolam are equally safe with respect to hemodynamic effects when used in titrated doses.

scholarly journals Comparison of dexmeditomidine and propofol for hemodynamic and recovery characteristics in dilatation and curettage.

2020 ◽  
Vol 27 (06) ◽  
pp. 1244-1248
Author(s):  
Raza Farrukh ◽  
Waseem Sadiq Awan ◽  
Ahmed Hassan Khan ◽  
Asaad Rizwan Rana ◽  
Ahmed Aziz Jilani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Control Trial ◽  
Recovery Room ◽  
Recovery Time ◽  
Loading Dose ◽  
Dilatation And Curettage ◽  
Randomized Control ◽  
Group D ◽  
Trial Setting

Objectives: To evaluate the hemodynamic and recovery characteristics of dexmeditomidine and propofol in dilatation and curettage. Study Design: Randomized control trial. Setting: Department of Anaesthesia, DHQ Teaching Hospital Sargodha. Period: March 2016 to December 2017. Material & Methods: Patients undergoing dilatation & curettage were randomly divided into two groups, group P received IV propofol 1.5mg/kg slowly over 5 min and group D received dexmeditomidine at a loading dose of 1µg/kg followed by 0.5 µg/kg/h. During the procedure blood pressure and heart rate were compared in both groups. In the recovery room, recovery time was compared in both groups by using modified aldrete score. Results: In Group D, the decrease in heart rate was statistically significant when compared with group P. Both groups showed a decrease in MAP but results were not statistically significant when compared in both groups. Patients in group D were discharged earlier from recovery room than group P and results were statistically significant. Conclusion: Dexmeditomodine provides better recovery than propofol so it is a suitable drug for day care minor surgical procedures. Similarly dexmeditomidine is superior to propofol by providing less respiratory depression intraopertaively.

Dexmedetomidine versus midazolam sedation for autistic children undergoing electroencephalogram: a prospective randomized trial

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Hoda Shokri ◽  
Amr A. Kasem
Keyword(s):  
Oxygen Saturation ◽  
Success Rate ◽  
Pediatric Patients ◽  
Sedative Effect ◽  
Sedation Score ◽  
Loading Dose ◽  
Radiological Imaging ◽  
Autistic Children ◽  
Midazolam Group ◽  
Recovery Times

Abstract Background Dexmedetomidine procedural sedation for pediatric patients undergoing radiological imaging has proved to be effective and safe. Objective We compared the efficacy of outpatient sedation with intravenous dexmedetomidine versus intravenous midazolam in autistic children undergoing electroencephalogram. Patients and methods Forty pediatric autistic patients aged 6–11 years old undergoing electroencephalogram were studied. In the dexmedetomidine group, patients received a loading dose of IV dexmedetomidine 1 μg/kg slowly over 10 min followed by an IV infusion of dexmedetomidine 0.7 μg/kg/h stopped when Ramsay sedation score (RSS) reached 4. In the midazolam group (n = 20), patients received induction with a loading dose of 0.05 mg/kg midazolam given over 2 min, then wait another 2 to 5 min to evaluate the sedative effect. Additional doses of IV midazolam (0.05 mg/kg) were given until we reached RSS reached 4. Sedation score, induction time, recovery time, behavioral scores, parents’ satisfaction scores, success rate, oxygen saturation, and the incidence of complications as bradycardia and attacks of agitation were recorded. Results Dexmedetomidine was associated with shorter induction and recovery times(< 0.001) and higher percentage of oxygen saturation compared with midazolam group (P < 0.001). The dexmedetomidine group showed higher sedation and behavioral scores as well as success rate compared with midazolam. Parents’ satisfaction scores were significantly higher in the dexmedetomidine group. The incidence of agitation was significantly higher in the midazolam group compared with the dexmedetomidine group (p = 0.035). Conclusion Dexmedetomidine is a feasible sedation technique in autistic children undergoing outpatient electroencephalogram in terms of faster recovery and less incidence of complications.

Getting to know a new protocol in hypertension care

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Mona Lundin
Keyword(s):  
Blood Pressure ◽  
Digital Technology ◽  
Interaction Analysis ◽  
Medical Discourse ◽  
Graphical Form ◽  
Graph Data ◽  
Average Blood Pressure ◽  
Infrastructure Design

This study explores the use of a new protocol in hypertension care, in which continuous patient-generated data reported through digital technology are presented in graphical form and discussed in follow-up consultations with nurses. This protocol is part of an infrastructure design project in which patients and medical professionals are co-designers. The approach used for the study was interaction analysis, which rendered possible detailed in situ examination of local variations in how nurses relate to the protocol. The findings show three distinct engagements: (1) teasing out an average blood pressure, (2) working around the protocol and graph data and (3) delivering an analysis. It was discovered that the graphical representations structured the consultations to a great extent, and that nurses mostly referred to graphs that showed blood pressure values, which is a measurement central to the medical discourse of hypertension. However, it was also found that analysis of the data alone was not sufficient to engage patients: nurses' invisible and inclusion work through eliciting patients' narratives played an important role here. A conclusion of the study is that nurses and patients both need to be more thoroughly introduced to using protocols based on graphs for more productive consultations to be established. 

scholarly journals A Comparative Study of Dexmedetomidine and Propofol for Sedation in Middle Ear Surgery under Monitored Anaesthesia Care at VIMSAR, Burla, Odisha

2021 ◽  
Vol 8 (17) ◽  
pp. 1105-1110
Author(s):  
Pramod Kumar Palai ◽  
Sheela Ekka ◽  
Mahendra Ekka ◽  
Saurabh Agrawal ◽  
Sapan Kumar Jena
Keyword(s):  
Spectral Index ◽  
Middle Ear ◽  
Middle Ear Surgery ◽  
Loading Dose ◽  
Patient Anxiety ◽  
Ear Surgery ◽  
Rescue Analgesia ◽  
Patient’S Satisfaction ◽  
Anaesthesia Care ◽  
Group D

BACKGROUND Middle ear surgeries done under local anaesthesia require adequate patient sedation and analgesia to prevent patient anxiety and movement during surgical procedures. This study was undertaken to compare dexmedetomidine and propofol for their sedative and analgesic properties, safety profile, adverse events and recovery profile in patients undergoing middle ear surgery under monitored anaesthesia care. METHODS This is a prospective observational study. 96 patients of both sexes, of American society of anaesthesiologist (ASA) grade I or II, between 18 - 60 years of age were randomly divided into two groups; group D and group P consisting of 48 patients each. Patients in group D received a loading dose of injection dexmedetomidine 1 µg / kg I.V. over 10 minutes followed by an infusion at a rate of 0.5 µg / kg / hr. Patients in group P received a loading dose of injection propofol 75 µg / kg / min. I.V. over 10 min followed by an infusion at a rate of 50 µg / kg / min. Time taken to achieve the modified Aldrete score of 10 was compared between both the groups. Before discharge from post anaesthesia care unit (PACU), patient’s satisfaction with sedation & surgeon satisfaction was recorded on Likert scale. Time to rescue analgesia was compared. RESULTS The Bi-Spectral Index values in intra-operative period were on the lower side in the group D as compared to the corresponding values in the group P, but P values were statistically insignificant suggesting that both dexmedetomidine and propofol produced similar sedation. Time to rescue analgesia was greater for group D. CONCLUSIONS Having similar sedation effect, dexmedetomidine was better than propofol for sedation in patients undergoing middle ear surgery under monitored anaesthesia care. KEYWORDS Dexmedetomidine, Propofol, Monitored Anaesthesia Care, Bi-spectral Index

scholarly journals Controlled Hypotension for Functional Endoscopic Sinus Surgery: A Comparative study of Dexmedetomidine and Esmolol

2020 ◽  
Vol 24 (1) ◽  
pp. 37-49
Author(s):  
Md Shafiul Alam Shaheen ◽  
AKM Nurnobi Chowdhury ◽  
Kawsar Sardar ◽  
Mushfiqur Rahman ◽  
Sudhangshu Shekhar Biswas ◽  
...  
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sedation Score ◽  
Sinus Surgery ◽  
Effective Control ◽  
Controlled Hypotension ◽  
Fentanyl Consumption ◽  
Surgical Field ◽  
Group D

Background: Functional endoscopic sinus surgery (FESS) requires effective control of bleeding for better visibility of the operating field and reduced risk of injury to the optic nerve or the internal carotid artery. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objectives: Our study is undertaken to evaluate the efficacy of dexmedetomidine as a hypotensive agent in comparison to esmolol in Functional Endoscopic Sinus Surgery (FESS). Methods: Sixty (60) patients 20 – 50 years of age, ASA I/II scheduled for FESS were randomly assigned to two equal groups of 30 patients each. Patients of group D received dexmedetomidine 1µg/kg over 10 min before induction of anesthesia followed by 0.4 – 0.8 µg/kg/hr infusion during maintenance and group E received esmolol loading dose 1mg/kg was infused over one min followed by 0.4 – 0.8 mg/kg/hr infusion during maintenance to maintain mean arterial blood pressure (MAP) between (55 – 65 mmHg). The surgical field was assessed using Average Category Scale and average blood loss was calculated. Hemodynamic variables (MAP, HR); intraoperative fentanyl consumption and total recovery from anesthesia (Aldrete’s score ≥9) were recorded. Sedation score was determined at 10, 20, 30, 40 & 60 min after tracheal extubation and time to first analgesic demand was also recorded. Results:In both group D and group E reached the desired MAP (55–65 mmHg) with no inter group difference in MAP or HR. Mean intraoperative fentanyl consumption was significantly lower in group D than group E. Recovery time to achieved Aldrete’s score ≥9 were significantly lower in group E compared with group D.The sedation score were significantly lower in group E compared with group D at 10 minutes, 20 minutes and 30 minutes postoperatively. Time to first analgesic demand was significantly longer in group D. Conclusion: The result of this study showed that both dexmedetomidine and esmolol can be used as agents for controlled hypotension and are effective in providing ideal surgical field during FESS. But dexmedetomidine offers the advantage of inherent analgesic, sedative and anesthetic sparing effect. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 37-49

Mechanical and Dimensional Adaptation of Rat Aorta to Hypertension

1994 ◽  
Vol 116 (3) ◽  
pp. 278-283 ◽  
Author(s):  
T. Matsumoto ◽  
K. Hayashi
Keyword(s):  
Blood Pressure ◽  
Elastic Modulus ◽  
Wall Stress ◽  
Dimensional Change ◽  
Biological Tissues ◽  
Rat Aorta ◽  
Mechanical Adaptation ◽  
Male Wistar Rats ◽  
Load Effects

To investigate mechanisms of the mechanical adaptation of soft biological tissues to load, effects of hypertension on the mechanical properties and wall dimensions of thoracic aortas were studied in rats. Goldblatt hypertension was induced in male Wistar rats aged 8 to 9 weeks by constricting their left renal arteries. Two, 4, 8, or 16 weeks after the operation, thoracic aortas were excised and used to determine static pressure-diameter relations and wall dimensions. Wall thickness correlated significantly with the systolic blood pressure before sacrifice, Psys, at each period. The aortic hoop stress became almost constant at all Psys 2 weeks after the operation. On the other hand, the stress calculated for 100 and 200 mmHg correlated negatively with Psys. The incremental elastic modulus of the wall at Psys had a significant correlation with Psys having a positive slope at each period, although the correlation disappeared at 16 weeks after the operation. These results imply that: 1) thickness of the aortic wall increases very rapidly in response to hypertension; 2) wall stress developed by the in-situ blood pressure is kept constant at a normal level irrespective of hypertension; 3) elastic modulus of the wall of the hypertensive rats at the in-situ blood pressure becomes equal to the normal value after relatively long period of time; 4) in response to the alteration of the applied force, dimensional change appears much earlier than the change in the elastic properties.

Abstract P104: Renin Angiotensin System (RAS) Modulation in Hypertension Program by Maternal Intrauterine Malnutrition

Hypertension ◽  
2015 ◽  
Vol 66 (suppl_1) ◽  
Author(s):  
Rafael S Banti ◽  
Rodrigo Yokota ◽  
Danielle S Aragão ◽  
Adriana Souza ◽  
Amanda Pedroso ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renin Angiotensin System ◽  
Control Group ◽  
Ang Ii ◽  
Alternative Pathways ◽  
Angiotensin Peptides ◽  
Increased Risk ◽  
Ace Activity ◽  
Intrauterine Malnutrition ◽  
Group D

Intrauterine malnutrition (IM) during the early stages of development can alter the function of organs and tissues and can predict a lifetime of increased risk for adverse health outcomes, such as diabetes and hypertension. The kidney plays a key role in the development of hypertension programmed by IM, with the participation of the RAS. Our objectives were to study ACE activity and angiotensin peptides levels in tissues. Pregnants Wistar rats were separated into two groups: control group (C), fed ad libitum, and malnourished group (D) submitted to food restriction (diet 50% of the amount of feed consumed by the group C). After birth the offspring were kept as experimental groups C and D, respectively. At 4 months of age, the animals were sacrificed, heart and kidney tissues were collected to quantify angiotensin peptides and ACE activity. The offspring born with low birth weight. Kidney ACE activity was higher in group D compared to group C (299 ±86.7 vs. 253.4 ±84.82 mU/mg, p<0.05), differing from Heart (D versus C: 0.15 ± 0.08 vs. 0.24 ±0.09 mU/mg). Group D presented high blood pressure values compared to group C (140.6 ±2.8 vs. 124,3±2.6 mmHg). Kidney and heart Ang II levels were increased in group D being significant when compared to group C (238.26 ±25.1 vs. 161.85 ±45.6 pmol/g and 397.89±74.9 vs. 223.33±48.7 pmol/g, p<0.05, respectively). The same was observed for Ang I. The vasodilator peptide Ang1-7 levels in group D from kidney and heart were lower in comparison with group C, thus emphasizing an enabling environment for hypertension (220.74 ± 48.74 vs. 288.09 ± 47 pmol/g and 152.1±41.2 pmol/g vs. 228.93±41.2 pmol/g, p<0.05, respectively). Our results indicate that perturbed maternal nutritional status alters tissue RAS resulting in higher blood pressure in the offspring, demonstrated by increased renal ACE activity and Ang II levels, with reduced Ang 1-7. The increase of Ang I and II in the heart, despite low ACE activity in this tissue suggests the activation of RAS alternative pathways. This study describes for the first time that low levels of Ang 1-7 contributed to the early development of hypertension.

Abstract 15439: Lesion Complexity and Long-term Outcomes According to Mean Observed Blood Pressure After Percutaneous Coronary Intervention

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jong Il Park ◽  
Byung Jun Kim ◽  
Hun Tae Kim ◽  
Jung Hee Lee ◽  
Ung Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Percutaneous Coronary Intervention ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Long Term Outcomes ◽  
Percutaneous Coronary ◽  
Group A ◽  
Group B ◽  
Group D

Background: The guideline recommended strict blood pressure (BP) control for the patients treated with percutaneous coronary intervention (PCI). We aimed to evaluate the relationship between mean observed BP and long-term outcomes for patients with or without lesion complexity. Methods: A total of 1,470 patients who underwent PCI were investigated. We categorized the study population into four groups based on mean observed BP and lesion complexity (left main & three-vessel disease, chronic total occlusion, total stent length ≥60mm, or bifurcation two stenting): Group A (non-complex & systolic BP ≤120mmHg, n=310), Group B (non-complex & systolic BP >120mmHg, n=674), Group C (complex & systolic BP ≤120mmHg, n=131), and Group D (complex & systolic BP >120mmHg, n=355). We evaluated major adverse cardiovascular and cerebrovascular events (MACCEs), defined as cardiac death, myocardial infarction (MI), repeat target vessel revascularization, or stroke. Results: Well-controlled BP group (Group A&C) showed significantly lower systolic BP than uncontrolled BP group (Group B&D) (114.3±6.1mmHg vs. 130.7±7.6mmHg, p<0.001). MACCEs occurred less frequently in Group A (18.9%) than Group B (23.6%), Group C (22.7%), and Group D (33.6%) (p=0.001) at 8 years. After multivariate analysis, with Group A as a reference, the adjusted hazard ratio (HR) for MACCEs was 1.382 (95% confidence interval [CI] 0.978-1.954, p=0.067) for Group B, 1.559 (95% CI 0.957-2.540, p=0.075) for Group C, and 1.872 (95% CI 1.296-2.705, p=0.001) for Group D. In Cox regression model, although lesion complexity was not associated with MACCE, systolic BP≤120mmHg was an independent predictor for reduced rate of MACCE (HR 0.667, 95% CI 0.485-0.918, p=0.013). Conclusions: Mean observed systolic BP ≤120mmHg after PCI was independent predictor for reduced MACCEs regardless of lesion complexity. Key Words: Blood Pressure; Percutaneous Coronary Intervention; Lesion Complexity; Treatment Outcome

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