Defining intra-operative hypotension - a pilot comparison of blood pressure during sleep and general anaesthesia
Defining intra-operative hypotension - a pilot comparison of blood pressure during sleep and general anaesthesia
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DOI：
10.1111/j.1365-2044.2011.06657.x
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发表时间：
2011-05-01
期刊：
影响因子：
10.7
通讯作者：
Silbert, B. S.
中科院分区：
文献类型：
--
作者：
Soo, J. C. L.;Lacey, S.;Silbert, B. S.
P&gT；术中低血压的特殊价值的科学证明缺乏充分的证据。为了给出合适的血压测量值提供理论依据，我们使用自动无创动态血压测量设备记录了24小时的家庭血压测量。将这些血压与18名接受择期日间手术的受试者在全麻前和全麻期间测量的血压进行了比较。我们证实，与同一患者通常白天的血压相比，入院时的术前读数显著升高。动脉收缩压和平均动脉压增加的中位数分别为10(2-15[-5~59])mm Hg，p=0.003和10(5-14[-5~35])mm Hg，p=0.002。以入院时的血压测量为“基线”时，睡眠期间的收缩压和平均动脉压分别下降了41(30-46[6-83])mm Hg和34(26-36[6-58])mm Hg(p=0.001)。术中血压进一步下降：收缩压下降49(36-[15-96])毫米汞柱，平均动脉压下降36(26-46[8-66])毫米汞(p=0.001)。
P>The scientific justification for particular values of intra-operative hypotension is poorly substantiated. To provide a rationale for appropriate values we recorded blood pressure measurements at home for 24 h using an automated non-invasive ambulatory blood pressure measurement device. These blood pressures were compared with blood pressure measured before and during general anaesthesia in 18 subjects undergoing elective day surgery. We confirmed that a pre-operative reading taken upon admission to hospital is significantly elevated compared to a usual daytime blood pressure in the same patient. The median (IQR [range]) increases in systolic and mean arterial pressures were 10 (2-15 [-5 to 59]) mmHg, p = 0.003 and 10 (5-14 [-5 to 35]) mmHg, p = 0.002, respectively. When using this admission blood pressure measurement as a 'baseline', systolic and mean arterial pressures decreased during sleep by 41 (30-46 [6-83]) mmHg and 34 (26-36 [6-58]) mmHg, respectively (p = 0.001). This decreased even further intra-operatively: systolic blood pressure by 49 (36-64 [15-96]) mmHg and mean arterial pressure by 36 (26-46 [8-66]) mmHg (p = 0.001).