Paraskeva Anteia, Theodosopoulou Polyxeni
Department of Anesthesiology, Aretaieion University Hospital, Athens, Greece.
Saudi J Anaesth. 2022 Oct-Dec;16(4):481-484. doi: 10.4103/sja.sja_4_22. Epub 2022 Sep 3.
Major depressive disorder (MDD) represents the leading cause of mental disability worldwide. While relations between MDD and alterations to the cardiovascular system have been studied before, the autonomic dysfunction caused by the disease and the medical therapies involved during treatment has not been widely reported. Our case aims to prove such linkage exists and is a potent hazard during major operative procedures.
Studies have associated the disorder with a concomitant dysfunction of the autonomic nervous system, predisposing patients to hypertension. We present the case of a patient presenting with an intraoperative hypertensive spike that could be attributed to such a dysregulation of the autonomic system, in the absence of any other possible explanation.
The observed intraoperative hypertensive spike was managed pharmacologically, and the patient did not experience any further hemodynamic instability or postoperative complications.
Our case tries to highlight a disregarded aspect of perioperative management for patients suffering from MDD.
重度抑郁症（MDD）是全球精神残疾的主要原因。虽然此前已对MDD与心血管系统改变之间的关系进行过研究，但该疾病引起的自主神经功能障碍以及治疗期间所涉及的医学疗法尚未得到广泛报道。我们的病例旨在证明这种联系存在，并且在重大手术过程中是一种潜在风险。
研究表明该疾病与自主神经系统的伴随功能障碍有关，使患者易患高血压。我们报告了一例患者，其术中出现高血压峰值，在没有任何其他可能解释的情况下，可归因于自主系统的这种失调。
观察到的术中高血压峰值通过药物治疗得到控制，患者未出现任何进一步的血流动力学不稳定或术后并发症。
我们的病例试图突出MDD患者围手术期管理中一个被忽视的方面。
