Changes in blood pressure during induction of anesthesia and oral and maxillofacial surgery by type and timing of discontinuation of antihypertensive drugs.
Changes in blood pressure during induction of anesthesia and oral and maxillofacial surgery by type and timing of discontinuation of antihypertensive drugs.
复制标题
DOI：
10.2344/0003-3006-57.1.13
复制
发表时间：
2010-01-01
影响因子：
--
通讯作者：
Kotani, Junichiro
中科院分区：
文献类型：
--
作者：
Momota, Yoshihiro;Kaneda, Kazuhiro;Kotani, Junichiro
本研究的目的是评价129例接受全身麻醉降压治疗的患者在口腔颌面外科手术期间降压药物类别和停药时间对血压的影响。尽管降压治疗的类型不影响血压的变化，但在对刺激失去反应时和插管后5-15分钟的血压明显低于诱导前。住院病人的收缩压（SBP）与术中收缩压变化无显著相关性，但住院病人的收缩压与术中最低收缩压的差异较大。术前停止降压治疗的患者手术中血管加压药物的使用频率明显高于手术当日继续降压治疗的患者。这些发现提示术前适当的降压治疗对于最小化术中血压变化和预防围手术期并发症非常重要。接受降压治疗的患者围手术期应仔细监测降压药物与麻醉剂之间的相互作用，并尽量减少降压治疗的中断时间。
The purpose of this study was to evaluate the effects of an antihypertensive drug class and the timing of discontinuation of antihypertensive therapy on blood pressure during oral and maxillofacial surgery for 129 patients on antihypertensive therapy receiving general anesthesia. Blood pressures at loss of response to stimulation and 5-15 minutes after intubation were significantly lower than those before induction, although the type of antihypertensive therapy did not affect changes in blood pressure. No significant correlation was observed between systolic blood pressure (SBP) on the ward and change in SBP during surgery, though patients with higher blood pressure on the ward tended to exhibit larger differences between SBP on the ward and the lowest SBP during surgery. Frequency of use of vasopressors during surgery was significantly higher in patients who discontinued antihypertensive therapy on the day before surgery than in those who continued antihypertensive therapy on the day of surgery. These findings suggest that appropriate preoperative antihypertensive therapy is important for minimizing change in blood pressure during surgery and preventing perioperative complications. Patients undergoing antihypertensive therapy should be carefully monitored perioperatively by observation for interactions between antihypertensive and anesthetic agents and minimizing interruption schedules for antihypertensive therapy.