上腺素可以预防老年患者的低血压在脊髓麻醉下与静脉输入的propofol镇静:一个随机对照试验
Hyungtae Kim1, Sooho Lee2, Won Uk Koh1
1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
在老年部手术患者的脊柱麻醉期间,持续输注诺阿基尼林有效地预防低血压. 这种方法可以减少低血压事件和流体需求,而不会增加术后并发症.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 心血管生理学心血管生理学
背景情况:
- 低血压是脊髓麻醉的常见且可能致命的副作用,特别是在患有并发症的老年患者中.
- 管理低血压至关重要,以确保患者的安全和有利的结果在这个人口.
- 普罗波镇静剂通常与脊柱麻醉同时使用,可能会影响血液动力学稳定性.
研究的目的:
- 为了研究连续输入诺亚上腺的疗效,预防低血压的老年患者接受关节手术在脊髓麻醉和普罗波镇静下.
- 为了比较接受预防性诺阿基尼林和接受标准护理的患者之间的低血压事件和其他血液动力学参数的发生率.
- 评估预防性上腺素对流体需求和尿液输出的影响.
主要方法:
- 一项随机对照试验,涉及70岁或以上的接受关节手术的患者.
- 患者被分配到对照组 (正常的盐水输液) 或在脊髓麻醉和普罗波福镇静后的诺尔上腺素组 (连续的诺尔上腺素输液).
- 主要结局是低血压事件的数量,次要结局包括液体输入,尿液输出和术后并发症.
主要成果:
- 与对照组相比,连续输入诺亚上腺素显著降低了低血压事件的数量 (p < 0.001).
- 接受上腺素治疗的患者需要较少的液体用于正常血量 (p = 0.008) 并有较大的尿量 (p = 0.019).
- 两组之间没有观察到术后并发症的显著差异.
结论:
- 预防性连续静脉输入诺亚上腺是预防低血压的有效策略,在接受关节手术的老年患者中使用脊柱麻醉和普罗波镇静.
- 这种干预有助于维持血液动力学稳定性,减少液体复苏需求,改善尿液输出.
- 在这种脆弱的患者群体中,上腺素输注提供了一种安全和有益的方法来管理脊柱麻醉诱导的低血压.
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