Key Risk Factors for Postoperative Hypotension in Nasopharyngeal Carcinoma Patients After Endoscopic Surgery: A Retrospective Study

BACKGROUND Endoscopic surgery has become increasingly important in management of nasopharyngeal carcinoma (NPC). However, limited research exists on postoperative hypotension in NPC patients undergoing endoscopic surgery. This retrospective study aimed to analyze the risk factors associated with postoperative hypotension in such patients. MATERIAL AND METHODS This retrospective study included NPC patients who underwent endoscopic surgery after radiotherapy at Guangdong Provincial People's Hospital between 2021 and 2023. Patients with systolic blood pressure (SBP) <90 mmHg or mean arterial pressure (MAP) <65 mmHg were categorized into the hypotension group. Multiple logistic regression analysis was performed to identify the risk factors associated with postoperative hypotension. RESULTS Among 264 patients, 86 (32.5%) experienced postoperative hypotension. Univariate analysis revealed significant associations between postoperative hypotension and factors such as sex, height, weight, admission SBP, admission MAP, preoperative hemoglobin level, and preoperative blood calcium level. Multivariate logistic regression identified height [odds ratio (OR): 0.957; 95% confidence interval (CI): 0.924-0.991], admission SBP (OR: 0.979; 95% CI: 0.963-0.995), preoperative blood calcium concentration (OR: 0.044; 95% CI: 0.003-0.734), and the use of dexmedetomidine during surgery (OR: 0.278; 95% CI: 0.091-0.848) as independent risk factors for postoperative hypotension. CONCLUSIONS Height, admission SBP, preoperative blood calcium concentration, and the use of dexmedetomidine during surgery were identified as independent risk factors for postoperative hypotension in NPC patients undergoing endoscopic surgery. Identifying and addressing these factors can help clinicians optimize perioperative management by carefully titrating dexmedetomidine doses, ensuring adequate preoperative blood pressure control, and correcting calcium imbalances to maintain hemodynamic stability.