Causes of low blood pressure after hip replacement surgery

Share
Share Article
Table of Contents Show
Print
Embed
Link

What’s happening in my body in the days and weeks after surgery?

Joint replacement is a major surgery and its effects can linger for days or weeks. Not only on the bone/joint which you had replaced, but in the rest of your body as well. These side effects can include pain, nausea, the blues or feeling extra emotional, and so forth. Talk to your doctor about any changes you notice after surgery whether it be physical or emotional.

Pain

Pain after surgery is expected. However, patients may be surprised to wake up with minimal pain at their surgical site, yet aches and pains elsewhere in their body. With modern anesthetic techniques like nerve blocks, pain signals from the actual site of surgery are blocked for the first 12-36 hours. This delayed onset of pain can catch some patients off guard. The good news is that pain at the surgery site generally peaks within the first week. Many patients may wake up from surgery with pain on other parts of their body. The operating room table, as well as positioning and manipulation of your body during surgery, can result in aches and pains throughout your body. These pains generally pass quickly without any treatment.

Nausea

One of the more unpleasant side effects of surgery is nausea. Several different culprits may be to blame. Low blood pressure, low blood sugar, or dehydration after surgery can cause lightheadedness, dizziness and nausea. Intravenous fluids can be given during and after the procedure to help decrease the risk of these problems.

General anesthesia and sedative medications used during surgery can cause nausea, as can the narcotic pain medications used during and after surgery. These effects can usually be combated with anti-nausea medication. Usually, postoperative nausea and vomiting passes fairly quickly within the first few hours of the procedure. Patients who have a history of nausea and vomiting after surgery should talk to their surgeon and anesthesiologist so the team can be better prepared to prevent the unpleasant feeling before it starts.

Sore throat

Many patients wake up with a sore throat and some hoarseness. General anesthesia often requires a breathing tube be placed into a patient’s lungs, which can irritate the throat during surgery. However, even without a breathing tube, sore throat is common after surgery. Anesthetic medications can decrease saliva production and cause dry throat. Also, the cold, dry air in the operating room can result in throat irritation as well. Typically, most sore throats and hoarseness after surgery resolve within the first day or two without any treatment.

Confusion

Just as when you first wake up in the morning, you may wake up from surgery feeling groggy. This is due to the medications given to keep you asleep during the procedure. Many anesthetic medications are out of your system within the first 24-48 hours and your mental sharpness should get back to normal relatively quickly. Older patients, and those with underlying dementia, are at risk for confusion that may come and go in the first few days to weeks after surgery. Typically, this resolves with minimal environmental changes and reorienting the confused person.

Fever

Low-grade fevers (less than 101.1 F) are common during the first few days after surgery. When you’re under anesthesia or lying flat for extended periods of time, your lungs don’t work as hard as they normally do. As a result, some areas of your lungs temporarily close off. After surgery, this can cause a low-grade fever. This condition, called atelectasis, can be prevented and treated by sitting up in bed instead of lying down, as well as deep breathing to re-inflate your lungs fully.

Slight increases in body temperature can also result from the stress response your body performs during surgery, as well as the healing effort your body makes after surgery. Fevers that don’t go away on their own or gets worse may be signs of a more significant problem like pneumonia, urinary tract infection, surgical infection, or blood clot.

While many of these side effects of surgery are considered normal, it’s important to talk to your doctor if you’re concerned about the way you feel after surgery, as it could indicate a more significant problem.

You can also read more about some of the risks associated with your particular surgery by clicking the corresponding link here:

Please let us know how useful this article was to you

Thank you for rating this article.

More by Charles Lawrie, M.D.:

Is low blood pressure common after hip surgery?

Hypotension occurs commonly during hip fracture repair, especially in the case of older patients with greater numbers of comorbidities [12]. A prospective observational study showed that 89% of patients experienced intraoperative hypotension during hip fracture surgery [5].

What is a dangerously low blood pressure after surgery?

In both studies, postoperative hypotension was subjectively defined as clinically important hypotension, i.e., when systolic blood pressure dropped to less than 90 mmHg for any duration requiring intervention during postoperative day 0 to 3.

What is the most common reason for hypotension after surgery?

The authors believe, however, that the most common cause of postoperative hypotension is that group of hematological factors which include transfusion reactions, hemolysis due to distilled water during transurethral resections, and acute or chronic loss of blood.

What is considered a dangerously low blood pressure?

A sudden fall in blood pressure can be dangerous. A change of just 20 mm Hg — a drop from 110 mm Hg systolic to 90 mm Hg systolic, for example — can cause dizziness and fainting. And big drops, such as those caused by uncontrolled bleeding, severe infections or allergic reactions, can be life-threatening.