da Silva Neto Walter Viterbo, Azevedo Giselli Santos, Coelho Fernanda Oliveira, Netto Eduardo Martins, Ladeia Ana Marice
Escola Bahiana de Medicina e Saúde Pública da Fundção Bahiana para o Desenvolvimento das Ciências, Salvador, BA.
Rev Bras Anestesiol. 2008 Jul-Aug;58(4):330-41. doi: 10.1590/s0034-70942008000400002.
Due to the high prevalence of hypertension, the increase in life expectancy, and improvement of diagnostic methods and surgical techniques, this comorbidity will be increasingly more common in surgical patients. The objective of this study was to evaluate the behavior of the hemodynamic variables during anesthetic induction in treated hypertensive patients.
This is an observational study on the behavior of hemodynamic parameters (systolic blood pressure, diastolic blood pressure, and heart rate) during the anesthetic induction of hypertensive and normotensive patients scheduled for elective surgeries under general anesthesia, at four moments: preparation (MP), drug (MD), laryngoscopy/intubation (ML), and 5 minutes after laryngoscopy/intubation (ML5).
The sample was composed of 128 patients divided into two groups: hypertensive (GH) and normotensive (GN). Diastolic blood pressure was reduced at MD in both groups, with a smaller percentage reduction in GH (18.3 +/- 14.0% versus 23.0 +/- 11.4%, p = 0.04). There was an increase in SBP and DBP at ML in both groups, with smaller percentage reductions in GH (8.2 +/- 16.3% versus 18.2 +/- 21.2%, p < 0.01; 8.6 +/- 20.2% versus 25.0 +/- 27.9%, p < 0.01, respectively for DBP and SBP). As for ML5, HR, SBP and DBP did not show significant differences between both groups.
Hypertensive patients under treatment and with controlled blood pressure levels demonstrated greater hemodynamic stability during anesthetic induction.
由于高血压患病率高、预期寿命增加以及诊断方法和手术技术的改进，这种合并症在外科手术患者中将会越来越常见。本研究的目的是评估接受治疗的高血压患者在麻醉诱导期间血流动力学变量的变化情况。
这是一项关于高血压患者和血压正常患者在全身麻醉下进行择期手术的麻醉诱导过程中血流动力学参数（收缩压、舒张压和心率）变化情况的观察性研究，观察四个时间点：准备阶段（MP）、用药阶段（MD）、喉镜检查/插管阶段（ML）以及喉镜检查/插管后5分钟（ML5）。
样本由128名患者组成，分为两组：高血压组（GH）和血压正常组（GN）。两组在用药阶段舒张压均降低，高血压组降低的百分比更小（18.3±14.0%对23.0±11.4%，p = 0.04）。两组在喉镜检查/插管阶段收缩压和舒张压均升高，高血压组升高的百分比更小（舒张压和收缩压分别为8.2±16.3%对18.2±21.2%，p < 0.01；8.6±20.2%对25.0±27.9%，p < 0.01）。至于喉镜检查/插管后5分钟，两组心率、收缩压和舒张压均无显著差异。
接受治疗且血压水平得到控制的高血压患者在麻醉诱导期间表现出更大的血流动力学稳定性。
