Identification of risk factors for post-induction hypotension in patients receiving 5-aminolevulinic acid: a single-center retrospective study
Identification of risk factors for post-induction hypotension in patients receiving 5-aminolevulinic acid: a single-center retrospective study
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DOI：
10.1186/s40981-020-00340-9
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发表时间：
2020-05-12
影响因子：
0.9
通讯作者：
Yokoyama, Masataka
中科院分区：
文献类型：
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作者：
Yatabe, Tomoaki;Karashima, Takashi;Yokoyama, Masataka
背景 5-氨基乙酰丙酸 (5-ALA) 可用作光动力剂，但其使用通常会导致低血压。尽管避免平均动脉压 (MAP) < 60 mmHg 很重要，但使用 5-ALA 时 MAP < 60 mmHg 的发生率尚不清楚。因此，我们进行了一项回顾性研究来评估诱导后低血压的发生率，并确定这种现象的危险因素。方法连续纳入172例接受经尿道膀胱肿瘤切除术或开颅手术并使用5-ALA的患者。主要结局是麻醉诱导后低血压的发生率，定义为麻醉诱导后头 1 小时内 MAP < 60 mmHg。我们将参与者分为正常血压组（N 组）和低血压组（L 组）。结果诱导后低血压发生率为70%（L组=121，N组=51）。多变量分析显示，女性是诱导后低血压的独立因素（比值比 [OR] 3.95；95% 置信区间 [CI] 1.21-12.97；p = 0.02）。麻醉诱导和全身麻醉前收缩压< 100 mmHg也被确定为显着的独立因素（分别为OR 13.30；95% CI 1.17-151.0；p = 0.04；OR 25.84；95% CI 9.80-68.49；p < 0.001）。结论 使用5-ALA的患者诱导后低血压的发生率为70%。女性、麻醉诱导前收缩压<100 mmHg以及全身麻醉可能是使用5-ALA时诱导后低血压的独立因素。
Background 5-Aminolevulinic acid (5-ALA) is useful as a photodynamic agent, but its use commonly leads to hypotension. Although avoiding a mean arterial pressure (MAP) < 60 mmHg is important, the incidence of MAP < 60 mmHg when using 5-ALA is unclear. Therefore, we conducted a retrospective study to assess the incidence of post-induction hypotension and identified risk factors of this phenomenon. Methods One-hundred and seventy-two consecutive patients who underwent transurethral resection of the bladder tumor or craniotomy with the use of 5-ALA were enrolled. The primary outcome was the incidence of post-induction hypotension, defined as MAP < 60 mmHg during the first 1 h after anesthesia induction. We divided participants into the normal blood pressure group (group N) and the hypotension group (group L). Results The incidence of post-induction hypotension was 70% (group L = 121, group N = 51). Multivariate analysis revealed that female sex was an independent factor of post-induction hypotension (odds ratio [OR] 3.95; 95% confidence interval [CI] 1.21-12.97; p = 0.02). Systolic blood pressure < 100 mmHg before anesthesia induction and general anesthesia were also identified as significant independent factors (OR 13.30; 95% CI 1.17-151.0; p = 0.04 and OR 25.84; 95% CI 9.80-68.49; p < 0.001, respectively). Conclusions The incidence of post-induction hypotension was 70% in patients using 5-ALA. Female sex, systolic blood pressure < 100 mmHg before anesthesia induction, and general anesthesia might be independent factors of post-induction hypotension when using 5-ALA.