俯卧位脊柱手术患者远端桡动脉压与前臂桡动脉压的一致性：一项前瞻性、自身对照、观察性研究。

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study.

机构信息

Department of Anesthesiology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China.

Department of Anesthesiology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China.

出版信息

J Int Med Res. 2023 Aug;51(8):3000605231188285. doi: 10.1177/03000605231188285.

DOI:10.1177/03000605231188285

PMID:37646630

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10469259/

Abstract

OBJECTIVE

To test agreement and interchangeability between distal (dRA) and forearm radial arterial (RA) pressures (AP) during general anesthesia (GA) for prone spinal surgery.

METHODS

This prospective observational study involved 40 patients scheduled for GA spinal surgery. The right dRA and left forearm RA were cannulated in all patients to continuously measure invasive blood pressures (IBP). We compared the agreement and trending ability of systolic AP (SAP), diastolic AP (DAP), and mean AP (MAP) at each site 15 minutes after tracheal intubation, start of surgery, 30 and 60 minutes after the start of surgery, and after skin suturing.

RESULTS

Paired BP values (n = 184) (37 cases) were analyzed. The bias (standard deviation), limits of agreement, and percentage error were: SAP: 0.19 (3.03), -5.75 to 6.12, and 5.04%; DAP: -0.06 (1.75), -3.50 to 3.38, and 5.10%; and MAP: 0.08 (1.52), -2.90 to 3.05, and 3.54%, respectively. The linear regression coefficients of determination were 0.981, 0.982, and 0.988 for SAPs, DAPs, and MAPs, respectively; four-quadrant plot concordance rates were 95.11%, 92.03%, and 92.66%, respectively.

CONCLUSION

All arterial BPs showed good agreement and trending capabilities for both the dRA and RA. The dRA may be substituted for the RA in IBP monitoring.

摘要

目的

测试全身麻醉（GA）下俯卧位脊柱手术时远端桡动脉（dRA）和前臂桡动脉（RA）压力（AP）的一致性和互换性。

方法

本前瞻性观察研究纳入了 40 例行 GA 脊柱手术的患者。所有患者均在右侧 dRA 和左侧前臂 RA 置管，以连续测量有创血压（IBP）。我们比较了气管插管后 15 分钟、手术开始时、手术开始后 30 分钟和 60 分钟以及皮肤缝合后，每个部位的收缩压（SAP）、舒张压（DAP）和平均动脉压（MAP）的一致性和趋势能力。

结果

分析了配对的 BP 值（n=184）（37 例）。偏倚（标准差）、一致性界限和误差百分比分别为：SAP：0.19（3.03），-5.75 至 6.12，5.04%；DAP：-0.06（1.75），-3.50 至 3.38，5.10%；MAP：0.08（1.52），-2.90 至 3.05，3.54%。SAP、DAP 和 MAP 的线性回归系数分别为 0.981、0.982 和 0.988；四象限图一致性率分别为 95.11%、92.03%和 92.66%。