PDF(Pubmed)
Abstract：
BACKGROUND: Post-induction hypotension (PIH) often occurs during general anesthesia induction. This study aimed to investigate blood catecholamine levels during induction of general anesthesia in patients with PIH undergoing laparoscopic cholecystectomy.
METHODS: This prospective study included 557 adult patients who underwent laparoscopic cholecystectomy under general anesthesia. PIH was defined as a greater than 20% decrease in systolic blood pressure from the pre-induction value, a systolic arterial pressure of less than 90 mmHg, or both. Plasma concentrations of epinephrine and norepinephrine during the induction of general anesthesia were determined using enzyme-linked immunosorbent assay. Multivariate logistic regression analysis evaluated the association between the clinical factors and PIH.
RESULTS: Of the 557 patients, 390 had PIH, and the remaining 167 were allocated to the non-PIH group. Changes in blood adrenaline, noradrenaline levels, or both were more pronounced in the PIH than in the non-PIH group (p<0.05). Age, body mass index, a history of hypertension, preoperative systolic blood pressure, and propofol or sufentanil dose were independent predictors of PIH.
CONCLUSIONS: The changes of blood catecholamines in patients with more stable hemodynamics during the induction of general anesthesia are smaller than that in patients with post-induction hypotension.
BACKGROUND: ChiCTR2200055549, 12/01/2022.
METHODS: This prospective study included 557 adult patients who underwent laparoscopic cholecystectomy under general anesthesia. PIH was defined as a greater than 20% decrease in systolic blood pressure from the pre-induction value, a systolic arterial pressure of less than 90 mmHg, or both. Plasma concentrations of epinephrine and norepinephrine during the induction of general anesthesia were determined using enzyme-linked immunosorbent assay. Multivariate logistic regression analysis evaluated the association between the clinical factors and PIH.
RESULTS: Of the 557 patients, 390 had PIH, and the remaining 167 were allocated to the non-PIH group. Changes in blood adrenaline, noradrenaline levels, or both were more pronounced in the PIH than in the non-PIH group (p<0.05). Age, body mass index, a history of hypertension, preoperative systolic blood pressure, and propofol or sufentanil dose were independent predictors of PIH.
CONCLUSIONS: The changes of blood catecholamines in patients with more stable hemodynamics during the induction of general anesthesia are smaller than that in patients with post-induction hypotension.
BACKGROUND: ChiCTR2200055549, 12/01/2022.
摘要：
背景：诱导后低血压（PIH）通常发生在全身麻醉诱导期间。本研究旨在探讨妊娠高血压综合征患者腹腔镜胆囊切除术全麻诱导期间血儿茶酚胺水平。
方法：本前瞻性研究纳入557例全身麻醉下行腹腔镜胆囊切除术的成年患者。PIH被定义为收缩压从诱导前值下降超过20%，收缩压低于90mmHg,或者两者兼而有之。采用酶联免疫吸附试验测定全身麻醉诱导过程中肾上腺素和去甲肾上腺素的血浆浓度。多因素logistic回归分析评价临床因素与PIH的相关性。
结果：在557名患者中，390患有PIH，其余167人被分配到非PIH组.血液中肾上腺素的变化，去甲肾上腺素水平,与非PIH组相比，PIH组或两者更明显（p<0.05）。年龄,身体质量指数,有高血压史,术前收缩压,丙泊酚或舒芬太尼剂量是PIH的独立预测因子。
结论：全身麻醉诱导时血流动力学较稳定的患者血儿茶酚胺的变化小于诱导后低血压患者。
背景：ChiCTR2200055549，12/01/2022。
方法：本前瞻性研究纳入557例全身麻醉下行腹腔镜胆囊切除术的成年患者。PIH被定义为收缩压从诱导前值下降超过20%，收缩压低于90mmHg,或者两者兼而有之。采用酶联免疫吸附试验测定全身麻醉诱导过程中肾上腺素和去甲肾上腺素的血浆浓度。多因素logistic回归分析评价临床因素与PIH的相关性。
结果：在557名患者中，390患有PIH，其余167人被分配到非PIH组.血液中肾上腺素的变化，去甲肾上腺素水平,与非PIH组相比，PIH组或两者更明显（p<0.05）。年龄,身体质量指数,有高血压史,术前收缩压,丙泊酚或舒芬太尼剂量是PIH的独立预测因子。
结论：全身麻醉诱导时血流动力学较稳定的患者血儿茶酚胺的变化小于诱导后低血压患者。
背景：ChiCTR2200055549，12/01/2022。
