根据一天中的时间,诱导后低血压发生率的差异:
Johan T M Tol1, Arjen J G Meewisse1, Sijm H Noteboom2
1Department of Anaesthesiology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands.
Journal of clinical anesthesia
|September 4, 2025
概括
早晨麻醉诱导增加了诱导后低血压的风险. 这项研究发现,与下午相比,在接受麻醉的患者中,低血压和血压下降的比例更高.
科学领域:
- 麻醉学
- 生理学
- 循环节律
背景情况:
- 包括血压和荷尔蒙分泌在内的生理过程表现出白天节律.
- 这些日常变化可能会影响患者对麻醉的敏感性.
- 麻醉诱导的时间可能会影响麻醉后的结果.
研究的目的:
- 调查一天中的麻醉诱导时间影响诱导后低血压的发生率的假设.
- 分析早晨与下午麻醉诱导和低血压之间的关系.
- 探讨二次结果,如显著的血压下降和重心灵敏度.
主要方法:
- 对760名选择性非心脏手术患者的前性收集数据进行了分析.
- 进行全身麻醉,并监测血压.
- 主要终点:诱导后低血压的发生率 (平均动脉压≥65mmHg1分钟).
主要成果:
- 当在早上诱导麻醉时,诱导后低血压的发生率显著增加 (OR1. 48, p=0. 049).
- 平均动脉压在早上下降超过30%的情况也更为常见 (OR1.45, p=0. 0499).
- 在早晨和下午的诱导过程中,没有观察到重反射灵敏度的显著差异.
结论:
- 早晨的麻醉诱导与诱导后低血压的发生率较高有关.
- 结果与已知的生理日间变化一致,但可能受到未测量的混因素的影响.
- 需要进一步的随机研究来证实晨间麻醉诱导和低血压之间的因果关系.
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