外周注射吗啡通过减轻交感神经系统过活性的作用来降低术后高血压
M J Breslow1, D A Jordan, R Christopherson
1Department of Anesthesiology/Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Md 21205.
JAMA
|June 23, 1989
概括
通过降低交感神经系统活动,内注射吗啡硫酸盐有效地降低了大动脉手术后的术后高血压. 这种干预也减少了疼痛和需要额外的阿片类止痛药.
科学领域:
- 麻醉学 麻醉学
- 心血管外科心血管外科
- 药理学 药理学 是一个学科.
背景情况:
- 手术后高血压是腹腔大动脉手术后的常见并发症.
- 交感神经系统的过度活动与它的发展有关.
- 需要有效的管理策略来减轻这种风险.
研究的目的:
- 评估同情神经系统过活性的作用,在腹腔大动脉手术后的术后高血压.
- 评估外注吗啡硫酸盐在减轻这种反应中的有效性.
主要方法:
- 一项随机,双盲,安慰剂控制的研究,涉及24名接受腹腔大动脉手术的成年患者.
- 外周注射吗啡硫酸盐 (6毫克) 与液安慰剂的使用.
- 监测疼痛评分,血中诺上腺素,上腺素和氨酸压缩素水平以及血压.
主要成果:
- 接受外腔末吗啡的患者需要更少的腹腔末吗啡,并报告了较低的疼痛评分.
- 在外注式吗啡组中观察到显著较低的血诺上腺素水平.
- 吗啡组中需要治疗高血压的患者较少,手术后整体血压较低.
结论:
- 交感神经系统活动,而不是上腺上腺或阿尔金因压缩液,驱动着前列腺外科手术后的高血压.
- 外围注射麻醉剂,特别是吗啡硫酸盐,有效地减轻了这种同情反应,并降低了术后高血压.
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