Abstract: Objective To investigate the effects of different blood pressure (BP) management strategy on postoperative myocardial injury in the elderly patients undergoing spinal surgery. Methods A total of 60 elderly patients undergoing posterior lumbar interbody fusion (PLIF) surgery were randomly divided into standardized management group (group S, n=30) and individualized management group (group I, n=30). Group S maintained the level of intraoperative mean arterial pressure (MAP) at ≥ 65 mmHg or maintained the decrease ≤30% of the baseline level, and group I maintained MAP at 90% to 110% of the baseline level.The blood pressure and heart rate at preoperative visit (T0), before anesthesia (T1), at the beginning of surgery (T2), at the time of spinal decompression (T3), at the end of surgery (T4) and 24 h after surgery (T5) were recorded, and the levels of high sensitivity troponin T (hsTnT), serum creatinine (Cr) and blood urea nitrogen (BUN) were detected before and 24 h after surgery.The incidence of myocardial injury after non-cardiac surgery (MINS) was recorded in 2 groups. Results During the period of intraoperative spinal canal decompression, the level of MAP was significantly higher and the heart rate was significantly lower in group I than those in group S (P<0.05). The intraoperative urine volume in group I was higher than that in group S (P<0.05). The levels of hsTnT, Cr and BUN in group I were significantly lower than those in group S 24 h after operation (P<0.05).MINS occurred in 2 patients (6.7%) in group I and 10 patients (33.3%) in group S, with statistical difference (P<0.05). Conclusions Individualized BP management strategy can reduce the incidence of postoperative MINS in the elderly patients undergoing PLIF. It also reduces the levels of Cr and BUN.

Key words: blood pressure management, aged, spinal surgery, myocardial injury, high sensitivity troponin T