Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
BMJ Open. 2023 Jan 30;13(1):e067400. doi: 10.1136/bmjopen-2022-067400.
Post-induction hypotension (PIH), which is prevalent among elderly patients, is associated with adverse perioperative outcomes. As a critical part of blood pressure regulation, baroreflex control is believed to be closely related to intraoperative blood pressure fluctuations. Spontaneous baroreflex sensitivity and heart rate variability measurement can aid evaluation of patients' autonomic function. This study aims to determine the association between preoperative decreased baroreflex function and PIH in elderly patients.
This prospective cohort study will enrol patients who are 65 years old and above, scheduled for elective non-cardiac surgery under general anaesthesia, and American Society of Anesthesiologists physical status I-III (n=180). Baseline assessment will include routine preoperative evaluations as well as symptoms and anamneses associated with baroreflex failure. Preoperative autonomic function monitoring will be performed through 20 min of continuous beat-to-beat heart rate and blood pressure monitoring using LiDCO rapid (Masimo Corporation, USA). The primary outcome will be PIH. Detailed use of anaesthetic agents during induction and maintenance will be documented for adjustment in multivariable analyses.
The Research Ethics Committee of Peking Union Medical College Hospital approved the study protocol (I-22PJ008). We aim to publish and disseminate our findings in peer-reviewed journals.
NCT05425147.
在老年患者中普遍存在的诱导后低血压（PIH）与围手术期不良结局相关。作为血压调节的关键部分，压力反射控制被认为与术中血压波动密切相关。自主神经功能评估可以通过测量自发性压力反射敏感性和心率变异性来实现。本研究旨在确定老年患者术前压力反射功能下降与 PIH 之间的关系。
这是一项前瞻性队列研究，将纳入年龄在 65 岁及以上、接受全身麻醉下择期非心脏手术的患者（n=180）。基线评估将包括常规术前评估以及与压力反射衰竭相关的症状和病史。术前自主神经功能监测将通过 LiDCO rapid（Masimo Corporation，USA）进行 20 分钟连续的心率和血压监测。主要结局为 PIH。将详细记录诱导和维持期间麻醉剂的使用情况，以便在多变量分析中进行调整。
北京协和医学院医院的伦理委员会批准了该研究方案（I-22PJ008）。我们旨在将研究结果发表在同行评议的期刊上。
NCT05425147。
