Hypotension after induction of general anesthesia: occurrence, risk factors, and therapy. A prospective multicentre observational study
Hypotension after induction of general anesthesia: occurrence, risk factors, and therapy. A prospective multicentre observational study
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DOI：
10.1007/s00540-018-2532-6
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发表时间：
2018-10-01
影响因子：
2.8
通讯作者：
Cerny, Vladimir
中科院分区：
文献类型：
--
作者：
Jor, Ondrej;Maca, Jan;Cerny, Vladimir
背景全麻诱导后低血压（GAIH）在麻醉学实践中很常见，并会影响预后。方法在这项前瞻性多中心、横断面、观察性研究中，低血压定义为与全麻诱导前手术室首次测量值相比平均动脉压降低> 30%。在气管插管时立即（T-ETI）、插管后5分钟（T-5）和10分钟（T-10）测量血压。纳入了所有年龄> 18岁的在GA下接受择期非心脏手术的受试者。目标是描述GAIH发生，GAIH与选定的合并症，慢性药物，麻醉剂与GAIH的关联，以及用于纠正低血压的干预措施的类型和疗效。结果数据来自661例受试者，其GA与丙泊酚和舒芬太尼诱导，进行了分析。在36.5%的受试者中，在≥ 1个评估时间点观察到GAIH。在所有时间点，2.9%的受试者存在GAIH。GAIH的概率随着年龄、到达手术室时的高血压程度和糖尿病的存在而增加。吸入麻醉药的种类与GAIH的发生无关。干预纠正低血压的总有效率为94.4%。推注液体是最常用的干预措施，是96.4%effect.Conclusion GAIH率取决于年龄，术前血压失代偿的程度，和存在的II型糖尿病。
Background Hypotension after induction of general anesthesia (GAIH) is common in anesthesiology practice and can impact outcomes.Methods In this prospective multicenter, cross-sectional, observational study, the hypotension was defined as a decrease in mean arterial pressure of > 30% compared to the first measurement in the operation theatre before general anesthesia (GA) induction. Blood pressure was measured immediately at the time of endotracheal intubation (T-ETI), at five (T-5) and 10 (T-10) minutes after. All subjects aged > 18 years undergoing elective non-cardiac surgery under GA were included. The goals were description of GAIH occurrence, the association of GAIH with selected comorbidities, chronic medications, and anesthetics with GAIH, and the type and efficacy of interventions used to correct hypotension.Results Data from 661 subjects, whose GA was induced with propofol and sufentanil, were analyzed. In 36.5% of subjects, GAIH was observed at >= 1 of the assessed time points. GAIH was present in 2.9% subjects at all time points. The probability of GAIH is raising with age, degree of hypertension at time of arrival to theatre and presence of diabetes. The type of volatile anesthetic was not associated with the occurrence of GAIH. The overall efficiency of interventions to correct hypotension was 94.4%. Bolus fluids were the most often used intervention and was 96.4% effective.Conclusion GAIH rate depends on age, degree of blood pressure decompensation prior the surgery, and presence of diabetes mellitus type II.