Rose Michael, Murrell David
Provisional Fellow in Anaesthesia Royal North Shore Hospital Sydney, NSW, Australia.
Paediatr Anaesth. 2004 Apr;14(4):357-60. doi: 10.1046/j.1460-9592.2003.01233.x.
A 12-year-old male presented for a superficial parotidectomy for chronic parotitis. The patient had an unremarkable past medical history and was admitted on the day of surgery for his procedure without further anaesthetic or surgical review. During the patient's intraoperative course, higher than expected blood pressures were noted and treated with clonidine. After further high blood pressure readings in the postoperative care unit, close surveillance of blood pressures for the following 24 h was arranged. The hypertension was ongoing, and further examination and investigation confirmed the diagnosis of coarctation of the aorta. We examine the possible reasons for failure to diagnose this patient's hypertension preoperatively and suggest that there is a need for greater surveillance of blood pressures in the paediatric population presenting for surgery. A discussion of the significance of hypertension in paediatrics and recommendations for minimum standards of care to address shortcomings in the diagnosis and treatment of paediatric hypertension are proposed.
一名12岁男性因慢性腮腺炎接受腮腺浅叶切除术。该患者既往病史无异常，手术当天入院接受手术，未进行进一步的麻醉或手术评估。在患者的术中过程中，发现血压高于预期，并用可乐定进行治疗。在术后护理单元进一步测得高血压后，安排了接下来24小时对血压的密切监测。高血压持续存在，进一步检查和调查确诊为主动脉缩窄。我们研究了术前未能诊断出该患者高血压的可能原因，并建议对接受手术的儿科人群加强血压监测。本文还讨论了儿科高血压的重要性，并提出了针对儿科高血压诊断和治疗缺陷的最低护理标准建议。
