STUDIES OF ANAESTHESIA IN RELATION TO HYPERTENSION .2. HAEMODYNAMIC CONSEQUENCES OF INDUCTION AND ENDOTRACHEAL INTUBATION
STUDIES OF ANAESTHESIA IN RELATION TO HYPERTENSION .2. HAEMODYNAMIC CONSEQUENCES OF INDUCTION AND ENDOTRACHEAL INTUBATION
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DOI：
10.1093/bja/43.6.531
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发表时间：
1971-01-01
影响因子：
9.8
通讯作者：
FOEX, P
中科院分区：
文献类型：
--
作者：
PRYSROBERTS, C;GREENE, LT;FOEX, P
在一组16例未经治疗的高血压患者和一组20例接受抗高血压治疗的患者中研究了麻醉诱导，随后进行喉镜检查和气管插管的心电图和血液动力学反应。比较了五种不同的诱导剂，硫喷妥钠，美索己酮，丙苯胺，地西泮，和苯哌啶和氟哌利多联合诱导的神经阻滞剂的影响。神经阻滞剂引起的动脉低血压比任何其他药物，但只提供了轻微的保护比其他药物对高血压，心动过速和心律失常与喉镜检查和气管插管。在少数患者中，丙尼地和地西泮均引起剧烈但短暂的低血压，未进行进一步研究。与其在正常血压受试者中的作用不同，在高血压患者中，美索己酮比硫喷妥钠引起更大的低血压。基本原理是预防性阻断β-肾上腺素能受体，以防止高血压危象在喉镜检查和插管治疗和未经治疗的高血压患者。
The electrocardiographic and haemodynamic responses to the induction of anaesthesia, followed by laryngoscopy and endotracheal intubation have been studied in a group of 16 untreated hypertensive patients, and a group of 20 patients receiving antihypertensive therapy up to and including the day of operation. The influence of five different induction agents, thiopentone, methohexitone, propanidid, diazepam, and neuroleptanalgesia induced by a combination of phenoperidine and droperidol were compared. Neuroleptanalgesia caused less arterial hypotension than any of the other agents, but afforded only marginally more protection than other agents against hypertension, tachycardia and dysrhythmia associated with laryngoscopy and tracheal intubation. Both propanidid and diazepam caused dramatic but transient hypotension in a small number of patients and were not investigated further. Unlike its effects in normotensive subjects, methohexitone caused greater hypotension than thiopentone in hypertensive patients. The rationale is presented for the prophylactic blockade of beta-adrenergic receptors to prevent hypertensive crises during laryngoscopy and intubation in both treated and untreated hypertensive patients.