麻醉诱导后的低血压:目标控制输液与手动麻醉诱导的普罗波福尔
Serap Aktas Yildirim1, Lerzan Dogan2, Zeynep Tugce Sarikaya1
1Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul 34752, Turkey.
Journal of clinical medicine
|August 26, 2023
概括
与手动诱导相比,目标控制输注 (TCI) 显著降低了诱导后的低血压. 高血压,较低的中风体积指数和心脏功率输出预测低血压,突出显示TCI的血液动力学益处.
科学领域:
- 麻醉学 麻醉学
- 心血管生理学心血管生理学
背景情况:
- 诱导后低血压是麻醉期间常见的并发症.
- 目标控制输注 (TCI) 提供精确的药物输送,可能改善血液动力学稳定性.
- 手动诱导缺乏复杂的定位,冒着血液动力学不稳定的风险.
研究的目的:
- 为了比较TCI和手动麻醉诱导之间的诱导后低血压的发生率.
- 为了确定诱导后低血压的血液动力学风险因素.
主要方法:
- 200名患者 (ASA等级1-3) 被随机分配到TCI或手动普罗波福尔诱导.
- 使用压力记录分析方法监测血液动力学参数.
- 调整了普罗波的剂量,以保持双光谱指数在40-60之间.
主要成果:
- 诱导后的低血压在TCI组 (13%) 与手动组 (34%) 相比显著减少.
- 诱导时间在TCI中较长,但propofol剂量相似.
- 高血压,中风体积指数 (SVI) 降低,心脏功率输出 (CPO) 预测低血压.
结论:
- 与手动诱导相比,使用普罗波福的TCI诱导增强了血液动力稳定性.
- 诱导前的SVI和CPO,以及高血压,是诱导后低血压的关键预测因素.
相关概念视频
Parenteral Anesthetics: Overview
154
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
154
General Anesthesia: Overview
240
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
240
Local Anesthetics: Clinical Application as Spinal Anesthesia
676
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
676
Local Anesthetics: Clinical Application as Epidural Anesthesia
457
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
457
Stages of General Anesthesia
497
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
497
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.1K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.1K


