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飞利浦Intellivue MP50监护仪测量全身麻醉下诱发胆心反射手术中的无创和有创血压差异的研究。

Study of the disparity of noninvasive and invasive blood pressure measured by the Philips Intellivue MP50 monitor in surgeries inducing gall cardiac reflex under general anesthesia.

作者信息

Meng Xianghu, Zang Guanghui, Li Rui, Fan Longchang, Liu Jihong, Wang Zengjun

机构信息

Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Province.

Departments of Urology.

出版信息

Blood Press Monit. 2018 Feb;23(1):19-23. doi: 10.1097/MBP.0000000000000304.

Abstract

OBJECTIVE

The aim of the present study was to comprehensively compare noninvasive and invasive blood pressure (BP) measured by the Philips Intellivue MP50 monitor in surgeries that may induce gall cardiac reflex under general anesthesia.

PARTICIPANTS AND METHODS

Seventy-eight patients undergoing cholecyst or bile duct operations under general anesthesia were enrolled in our study. Both invasive (intraradial, femoral, or dorsalis pedis artery) and noninvasive (oscillometric) BP were monitored by the Philips Intellivue MP50 monitor simultaneously. Data were analyzed using Bland-Altman plots.

RESULTS

In a supine position during operations, between intraradial and oscillometric measurements, the bias and precision (mmHg) were 9.34±12.98 and 12.47±10.00 for systolic blood pressure (SBP) and 3.26±8.22 and 6.53±5.97 for diastolic blood pressure (DBP), between intrafemoral and oscillometric measurements, the bias and precision (mmHg) were 14.40±14.38 and 16.93±11.28 for SBP and 4.35±9.72 and 7.52±7.54 for DBP, between intradorsalis pedis and oscillometric measurements, the bias and precision (mmHg) were 15.69±14.37 and 16.91±12.91 for SBP and 0.99±7.69 and 5.67±5.27 for DBP.

CONCLUSION

The oscillometric BP showed poor agreement with intra-arterial BP in cholecyst or bile duct surgeries that may induce gall cardiac reflex under general anesthesia. Therefore, according to the present data, application of oscillometric BP measured by the Philips Intellivue MP50 monitor in these surgery patients under general anesthesia cannot be recommended generally.

摘要

目的

本研究旨在全面比较飞利浦Intellivue MP50监护仪在全身麻醉下可能诱发胆心反射的手术中所测量的无创和有创血压(BP)。

参与者与方法

本研究纳入了78例在全身麻醉下接受胆囊或胆管手术的患者。通过飞利浦Intellivue MP50监护仪同时监测有创(桡动脉、股动脉或足背动脉)和无创(示波法)血压。使用Bland-Altman图对数据进行分析。

结果

手术过程中仰卧位时,桡动脉与示波法测量之间,收缩压(SBP)的偏差和精密度(mmHg)分别为9.34±12.98和12.47±10.00,舒张压(DBP)分别为3.26±8.22和6.53±5.97;股动脉与示波法测量之间,SBP的偏差和精密度(mmHg)分别为14.40±14.38和16.93±11.28,DBP分别为4.35±9.72和7.52±7.54;足背动脉与示波法测量之间,SBP的偏差和精密度(mmHg)分别为15.69±14.37和16.91±12.91,DBP分别为0.99±7.69和5.67±5.27。

结论

在全身麻醉下可能诱发胆心反射的胆囊或胆管手术中,示波法血压与动脉内血压的一致性较差。因此,根据目前的数据,一般不建议在这些全身麻醉的手术患者中应用飞利浦Intellivue MP50监护仪测量的示波法血压。

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