在服用三环抗抑郁药的患者中诱导麻醉后的低血压-A病例系列
Mads Lodsgaard1, Birgitte Bech Melchiors1, Mogens Krøigaard1
1Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital, Gentofte, Denmark.
三环抗抑郁药 (TCA) 可以在麻醉期间引起严重的低血压. 这种情况模仿过敏过敏,但有效地用上腺素或诺亚上腺素治疗,而不是标准的血管压缩剂.
科学领域:
- 麻醉学 麻醉学
- 临床药理学 临床药理学
背景情况:
- 术内低血压是麻醉的常见并发症.
- 三环抗抑郁药 (TCA) 可以在手术期间导致严重的,抗血管压剂的低血压.
- 经常怀疑过敏症,但TCA呈现出明显的差异诊断.
研究的目的:
- 识别和描述患有术后低血压的患者,而在TCAs.
- 研究TCA诱导的低血压的临床特征和潜在机制.
- 为了区分这种低血压和过敏反应在没有升高的三酶的情况下.
主要方法:
- 来自丹麦麻醉过敏中心 (DAAC) 数据库 (2011-2019) 患者的回顾性分析.
- 纳入标准:低血压 (静脉压<75 mmHg) 是唯一的症状,过敏检查结果为负,并定期接受TCA治疗.
- 数据收集的重点是临床表现和对治疗的反应.
主要成果:
- 十名接受TCA治疗的患者被确定为单症状的外术期低血压.
- 低血压发作发生在麻醉诱导后的中位数为7.5分钟.
- 八名患者需要上腺素或诺上腺素来恢复血压;标准血管压缩剂的效果较差.
结论:
- 三环抗抑郁药 (TCA) 是外科手术期间低血压的重要原因,模仿过敏反应.
- 这种低血压的特点是对烯/乙的耐药性,但对上腺素/诺上腺素的反应性.
- 在麻醉期间对不明原因的低血压的差异诊断中应考虑TCA,特别是当血清三酶不升高时.
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