衰老、肥胖、血脂异常和医院房间高血压是与麻醉前相关的临床危险因素。

Ageing, obesity, dyslipidaemia, and hospital-room hypertension are clinical risk factors relating to pre-anaesthesia.

机构信息

Department of Anaesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, Tokyo 113-8431, Japan.

Department of Anaesthesiology and the Intensive Care Unit, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.

出版信息

Anaesthesiol Intensive Ther. 2020;52(2):110-118. doi: 10.5114/ait.2020.93755.

DOI:10.5114/ait.2020.93755

PMID:32200612

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10176532/

Abstract

BACKGROUND

Pre-anaesthesia hypertension (PAH) occurs when the blood pressure (BP) in patients before surgery, in the operating room, before anaesthesia induction, temporally elevates regardless of normal ambulatory recorded BP or self-measured BP at home. PAH might be caused by anxiety and mental stress about the anaesthesia and surgery. We know that most of the patients with sustained hypertension (SH) are elders, males, obese subjects, and dyslipidaemic subjects. Furthermore, most of the patients with white coat hypertension, which is caused by mental stress about the medical environment of an outpatient, clinic, and hospital ward, are elders, females, and non-smokers. In the present study, we investigated some relevant clinical characteristics influencing PAH.

METHODS

Sampling data on patients more than 20 years old, who underwent consecutive operations under general, intrathecal, or epidural anaesthesia were retrospectively collected from hospital records and anaesthesia records. Hospital-room hypertension (HH) was defined as systolic BP (sBP) greater than or equal to 140 mm Hg in the hospital room before anaesthesia and surgery. Operating-room hypertension (OH) was defined as sBP greater than or equal to 140 mm Hg in the operating room before anaesthesia induction.

RESULTS

112 and 119 patients belonged to the OH and operating-room normotension (ON) groups, respectively. The OH group members were significantly older than the ON group members. Body mass index in the OH group was significantly greater than in the ON group. The proportions of males, dyslipidaemic subjects, and non-smokers in the OH group were significantly higher than in the ON group. In the logistic regression analysis, age, body mass, dyslipidaemia, and HH were selected as significant factors that contribute independently to OH (odds ratios; 1.045, 1.031, 2.912, and 4.354, respectively).

CONCLUSIONS

The clinical characteristics of the patients with OH are: elders, obese subjects, dyslipidaemic subjects, and hospital-room hypertensive subjects. Ageing, obesity, dyslipidaemia, and HH are clinical risk factors relating to PAH.

摘要

背景

术前高血压（PAH）是指患者在手术前、手术室中、麻醉诱导前的血压（BP）升高，与正常门诊记录的 BP 或在家自测的 BP 无关。PAH 可能是由对麻醉和手术的焦虑和精神压力引起的。我们知道，大多数持续性高血压（SH）患者是老年人、男性、肥胖者和血脂异常者。此外，大多数由门诊、诊所和医院病房的医疗环境引起的精神压力导致的白大衣高血压患者是老年人、女性和不吸烟者。在本研究中，我们调查了一些影响 PAH 的相关临床特征。

方法

从医院记录和麻醉记录中回顾性收集了 20 岁以上连续接受全身、椎管内或硬膜外麻醉手术的患者的抽样数据。医院房间高血压（HH）定义为麻醉和手术前医院房间内收缩压（sBP）大于或等于 140mmHg。手术室高血压（OH）定义为麻醉诱导前手术室中 sBP 大于或等于 140mmHg。

结果

112 例和 119 例患者分别属于 OH 和手术室正常血压（ON）组。OH 组患者明显比 ON 组患者年龄大。OH 组的体重指数明显大于 ON 组。OH 组男性、血脂异常和不吸烟者的比例明显高于 ON 组。在逻辑回归分析中，年龄、体重、血脂异常和 HH 被选为独立导致 OH 的显著因素（比值比分别为 1.045、1.031、2.912 和 4.354）。