Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan.
Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Asia Pac J Ophthalmol (Phila). 2020 Jan-Feb;9(1):14-19. doi: 10.1097/01.APO.0000617932.60445.77.
To investigate effect of metabolic syndrome on blood pressure during cataract surgery with topical anesthesia.
A single-centered, retrospective case series.
Consecutive patients who were hospitalized and underwent phacoemulsification and insertion of intraocular lens with topical anesthesia in October 2016 were included. Perioperative blood pressure and pulse pressure were compared between patients with metabolic syndrome (metabolic group) and sex- and age-matched patients without metabolic syndrome (nonmetabolic group) at six time points: on admission, in the morning of the operation, 2 hours before the operation, at the point of entering the operation room, during the operation, and after the operation. Perioperative use of etizolam and nicardipine was compared between the two groups.
Thirty patients in the metabolic group and 30 in the nonmetabolic group were included. There was no difference in changes compared with the values on admission in systolic pressure and pulse pressure at any examination point between the two groups. There was no difference in changes in diastolic pressure between the two groups, except for at 2 hours before the operation (1.4 ± 9.6 mm Hg in the metabolic group vs -6.2 ± 8.5 mm Hg in the nonmetabolic group; P = 0.044). The number of patients who were administered etizolam was 5/30 (16.7%) in the metabolic group and 2/30 (6.7%) in the nonmetabolic group, showing no significant difference. No patients were administered intravenous nicardipine in either group.
Well-controlled metabolic syndrome did not affect the changes in perioperative blood pressure during cataract surgery with topical anesthesia.
研究代谢综合征对局麻下白内障手术期间血压的影响。
单中心回顾性病例系列。
纳入 2016 年 10 月连续因白内障行超声乳化术和眼内人工晶状体植入术并接受局部麻醉的住院患者。比较代谢综合征患者（代谢组）和性别、年龄匹配的无代谢综合征患者（非代谢组）在六个时间点（入院时、手术当天上午、手术前 2 小时、进入手术室时、手术期间和手术后）的围手术期血压和脉压。比较两组患者在围手术期使用艾司唑仑和尼卡地平的情况。
代谢组 30 例，非代谢组 30 例。两组患者在各检查点与入院时相比，收缩压和脉压的变化无差异。两组患者的舒张压变化无差异，除手术前 2 小时（代谢组为 1.4±9.6mmHg，非代谢组为-6.2±8.5mmHg；P=0.044）外。代谢组给予艾司唑仑的患者有 5/30（16.7%），非代谢组有 2/30（6.7%），差异无统计学意义。两组均未静脉给予尼卡地平。
控制良好的代谢综合征不会影响局部麻醉下白内障手术期间围手术期血压的变化。
