Prevention of orthostatic hypotension involves treating its causes and avoiding risk factors. Postoperative orthopedic surgery patients are at a high risk for developing orthostatic hypotension due to medications, possible dehydration, and prolonged immobility. Primary prevention of orthostatic hypotension is key.
To prevent orthostatic hypotension, the modifiable risk factors must be considered. First, the practitioner must assess the patient’s current medication regimen for high-risk medications (Table 1). If the patient is currently taking a high-risk medication, the practitioner must decide whether the medication is essential, whether it can be withheld during the healing period, or whether it can be changed to another agent that has less of a risk for orthostatic hypotension. The second modifiable risk factor that should be addressed is fluid volume depletion. A close watch of a patient’s input and output is required to maintain appropriate hydration. The third modifiable risk factor is immobility. Patients should receive prompt and appropriate physical therapy after an orthopedic procedure.