[硝普钠诱导的低血压用于小儿骨科手术]

[Sodium nitroprusside-induced hypotension for pediatric orthopedic surgery].

作者信息

Toyama Satoshi, Okada Chinobu, Ikeda Naoki

机构信息

Department of Anesthesia and ICU, National Center for Child Health and Development, Tokyo 157-8535.

出版信息

Masui. 2009 Feb;58(2):174-7.

PMID:19227170

Abstract

BACKGROUND

Induced hypotensive anesthesia is a well established technique in adult patients. We examined retrospectively the effect of sodium nitroprusside pediatric patients undergoing pelvic osteotomy with simultaneous femoral osteotomy.

METHODS

Twenty-three patients received sodium nitroprusside-induced hypotensive anesthesia (group N) and 14 patients received standard anesthesia (group C). In patients of Group N, a target mean arterial blood pressure of 50-60 mmHg was achieved by intravenous administration of sodium nitroprusside.

RESULTS

Significant differences were observed between the two groups in the amounts of intra-operative blood loss and fluid infusion. Group N had less intra-operative blood loss than Group C (Group N: 7.3 +/- 4.1 ml x kg(-1) vs. Group C: 10.9 +/- 4.0 ml x kg(-1), P<0.05). Group N had less intra-operative fluid infusion than Group C (Group N: 37.7 +/- 11.2 ml x kg(-1) vs. Group C: 53.9 +/- 15.0 ml x kg(-1), P<0.05). Urine output was not significantly different (Group N: 6.0 +/- 6.2 ml x kg(-1) vs. Group C: 7.0 +/- 5.7 ml x kg(-1), P=0.60). There were no side effects of sodium nitroprusside-induced hypotension.

CONCLUSIONS

These results suggest that sodium nitroprusside is a safe and effective drug for induced hypotension in pediatric patients.

摘要

背景

控制性低血压麻醉在成年患者中是一项成熟的技术。我们回顾性研究了硝普钠对接受骨盆截骨术同时行股骨截骨术的儿科患者的影响。

方法

23例患者接受硝普钠控制性低血压麻醉（N组），14例患者接受标准麻醉（C组）。在N组患者中，通过静脉输注硝普钠使平均动脉血压目标维持在50 - 60 mmHg。

结果

两组在术中失血量和液体输注量方面存在显著差异。N组术中失血量少于C组（N组：7.3±4.1 ml·kg⁻¹ vs. C组：10.9±4.0 ml·kg⁻¹，P<0.05）。N组术中液体输注量少于C组（N组：37.7±11.2 ml·kg⁻¹ vs. C组：53.9±15.0 ml·kg⁻¹，P<0.05）。尿量无显著差异（N组：6.0±6.2 ml·kg⁻¹ vs. C组：7.0±5.7 ml·kg⁻¹，P = 0.60）。硝普钠诱导低血压无副作用。