Ono Takashi, Iwasaki Takuya, Kawahara Kana, Agune Yuko, Mori Yosai, Nejima Ryohei, Aihara Makoto, Miyata Kazunori
Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan.
Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2023 Jan;261(1):147-154. doi: 10.1007/s00417-022-05815-2. Epub 2022 Aug 27.
Although perioperative blood-pressure control is important, especially for high-risk patients, no previous report has examined early monitoring of perioperative blood-pressure changes before cataract surgery. In this single-center, retrospective, observational study, we evaluated the early intervention for perioperative hypertension in cataract surgery with topical anesthesia.
Hospitalized patients who underwent phacoemulsification and intraocular-lens insertion and whose blood pressure was controlled using standardized management to start early monitoring and control (standardized group; 134 eyes of 134 patients) were compared to age- and sex-matched patients who underwent the same cataract surgery and whose blood pressure was controlled using conventional means (control group; 134 eyes of 134 patients). The perioperative blood pressure, pulse pressure, and heart rate were compared preoperatively, upon entering the operation room, and at the beginning, end, and after the operation.
Although there was no difference before the operation, the changes in systolic pressure in the standardized group were significantly lower at the point of entering the operation room, at the beginning of the operation, and at the end of the operation (P = 0.003, < 0.001, and < 0.001, respectively). No significant difference was observed between etizolam and nicardipine use.
Early monitoring and control of blood pressure in cataract surgery could effectively control perioperative hypertension without additional drug use and could be widely applied in the clinical setting.
尽管围手术期血压控制很重要，尤其是对于高危患者，但此前尚无报告对白内障手术前围手术期血压变化的早期监测进行研究。在这项单中心、回顾性、观察性研究中，我们评估了在表面麻醉下白内障手术中对围手术期高血压的早期干预。
将接受超声乳化白内障吸除术和人工晶状体植入术且通过标准化管理控制血压以开始早期监测和控制的住院患者（标准化组；134例患者的134只眼）与接受相同白内障手术且通过传统方法控制血压的年龄和性别匹配患者（对照组；134例患者的134只眼）进行比较。比较围手术期的血压、脉压和心率，分别在术前、进入手术室时、手术开始时、结束时及术后进行。
尽管术前无差异，但标准化组在进入手术室时、手术开始时和结束时收缩压的变化显著更低（分别为P = 0.003、<0.001和<0.001）。在使用艾司唑仑和尼卡地平之间未观察到显著差异。
白内障手术中早期监测和控制血压可有效控制围手术期高血压，无需额外用药，可在临床广泛应用。
