METHODS: This single-center, retrospective study included severe AS patients who underwent elective TAVR. Patients in the NAd group received a continuous prophylactic NAd infusion of 0.1 μg/kg/min from the time of anesthesia induction. The control group received inotropes and vasopressors as indicated by the occurrence of hypotension. The primary outcome was the lowest mean blood pressure (MBP) before the start of surgery.
RESULTS: The study included 68 patients in the NAd group and 113 in the control group. The lowest MBP before the start of surgery was significantly higher in the NAd group than in the control group (63 ± 15 vs 47 ± 13 mmHg, P < 0.01). MBP immediately before intubation was also significantly higher in the NAd group (75 ± 17 vs 57 ± 16 mmHg, P < 0.01). Differences in postoperative complications between the groups were negligible.
CONCLUSIONS: Continuous administration of NAd at 0.1 μg/kg/min in patients with severe AS might prevent hypotension during general anesthesia induction for TAVR.
方法:这种单中心,回顾性研究包括接受选择性TAVR的重度AS患者.NAd组的患者从麻醉诱导开始接受0.1μg/kg/min的持续预防性NAd输注。对照组根据低血压的发生情况接受肌力剂和血管加压药。主要结果是手术开始前的最低平均血压(MBP)。
结果:该研究包括NAd组68例患者和对照组113例患者。NAd组手术开始前最低MBP明显高于对照组(63±15vs47±13mmHg,P<0.01)。NAd组插管前的MBP也显着升高(75±17vs57±16mmHg,P<0.01)。两组之间术后并发症的差异可以忽略不计。
结论:重度AS患者持续给予0.1μg/kg/min的NAd可以预防TAVR全身麻醉诱导期间的低血压。