Department of Anesthesiology, Shioya Hospital, International University of Health and Welfare, Tomita 77, Yaita-shi, Tochigi, 329-2145, Japan.
J Anesth. 2013 Aug;27(4):521-7. doi: 10.1007/s00540-013-1568-x. Epub 2013 Mar 1.
A decrease in blood pressure is sometimes observed when a postsurgical patient is transferred to another bed after recovering from anesthesia. However, the mechanism behind this hypotension has not been completely elucidated. The purpose of this study was to investigate and compare changes in hemodynamic properties for possible causes of hypotension before and after transfer to another bed of postsurgical patients receiving general anesthesia, combined epidural and general anesthesia, or combined spinal and general anesthesia.
We studied 69 patients undergoing elective surgery who were randomized to receive anesthesia by one of the three methods. After surgery, the tracheal tube was removed, and each patient was transferred to another bed. Hemodynamic data recorded immediately before and after transfer of the patient to another bed were compared.
After transfer of patients receiving general anesthesia or combined epidural and general anesthesia, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and cardiac output (CO) decreased; heart rate (HR) and systemic vascular resistance (SVR) did not change. However, after transfer of patients receiving combined spinal and general anesthesia, SAP, DAP, HR, and CO decreased, but SVR did not change.
The decrease in blood pressure observed after transfer of a postsurgical patient to another bed after general, combined epidural and general, and combined spinal and general anesthesia was associated with a decrease in CO and no change in SVR, but HR decreased after combined spinal and general anesthesia, whereas it was unchanged after general and combined epidural and general anesthesia. The decrease in blood pressure is assumed to be caused by a decrease in venous return, and several reflexes might participate in this decrease of blood pressure, especially after combined spinal and general anesthesia.
术后患者从麻醉中恢复并转移到另一张床时，有时会观察到血压下降。然而，这种低血压的机制尚未完全阐明。本研究的目的是调查和比较接受全身麻醉、硬膜外联合全身麻醉或脊髓联合全身麻醉的术后患者在转移到另一张床前后的血液动力学特性变化，以寻找可能导致低血压的原因。
我们研究了 69 名接受择期手术的患者，他们被随机分为接受三种麻醉方法之一。手术后，拔出气管导管，每位患者都被转移到另一张床。比较患者转移到另一张床前后的血液动力学数据。
接受全身麻醉或硬膜外联合全身麻醉的患者转移后，收缩压（SAP）、舒张压（DAP）和心输出量（CO）下降；心率（HR）和全身血管阻力（SVR）不变。然而，接受脊髓联合全身麻醉的患者转移后，SAP、DAP、HR 和 CO 下降，但 SVR 不变。
全身麻醉、硬膜外联合全身麻醉和脊髓联合全身麻醉后，术后患者转移到另一张床时血压下降与 CO 下降有关，SVR 不变，但脊髓联合全身麻醉后 HR 下降，而全身麻醉和硬膜外联合全身麻醉后 HR 不变。血压下降被认为是由于静脉回流减少引起的，几个反射可能参与这种血压下降，尤其是在脊髓联合全身麻醉后。
