Journal of AdvancedMedical and Dental Sciences Research

Background: It is a standard practice to measure non-invasive blood pressure (NIBP) in the perioperative setting using oscillotonometric equipment. Measuring blood pressure (BP) in both the arms and their difference (IADs) is recommended by numerous guidelines to be performed at each first visit. The present study was conducted to investigating the influence of methodology of BP measurement on the IAD value. Materials & Methods: This study was conducted in the department of Anesthesiology in year 2017. It included 1240 subjects of both genders. Both systolic and diastolic blood pressure of both the arms was recorded using sphygmomanometer and stethoscope. Results: Out of 1240 subjects, males were 680 and females were 560. The difference was non- significant (P-0.1). There are differences between groups separated for measurement methods (simultaneous vs. sequential measurements), device (manual vs. automatic) and the number of readings (1 vs. 2 or more readings) used to determine IAD prevalence. The method of IAD performance had a significant influence on systolic (IAD ≥10 and 20 mm Hg) and diastolic (IAD ≥10) prevalence: sequential measurements led to a significant higher prevalence than simultaneous measurements (RR ranges from 2.4 to 4.6), the use of a manual BP device led to a significant higher prevalence than when using an automated device (RR ranges from 2.2 to 4.2). However, there was a strong relationship between devices and measurement methods: all, except one, simultaneous measurements were performed with automated devices. Conclusion: Method used for blood pressure evaluation has major influence on IAD differences. Blood pressure should be measured in both the arms to prevent overestimation and observer bias with one or two automatic devices and multiple readings should be taken.
Key words: Blood pressure, Stethoscope, Sphygmomanometer.