Department of Ophthalmology, Miyata Eye Hospital, 6-3 Kuraharacho, Miyakonojo, Miyazaki, 885-0051, Japan.
Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Jpn J Ophthalmol. 2024 Nov;68(6):669-675. doi: 10.1007/s10384-024-01124-9. Epub 2024 Sep 28.
Few studies have addressed the clinical impact of fluctuation in pulse rate before cataract surgery. This study aimed to determine the effectiveness of prior pulse monitoring and intervention to prevent blood pressure changes in patients undergoing cataract surgery under local anesthesia.
Retrospective study METHODS: Patients who underwent cataract surgery under local anesthesia were included. In the pulse rate (PR) group, intervention was performed on the basis of early monitoring of blood pressure and PR changes. In the conventional group, blood pressure was managed on the basis of blood pressure alone. Systolic blood pressure, diastolic blood pressure, intraoperative nicardipine use, and physician consultation time were retrospectively compared between the groups.
The study included 684 eyes from 684 patients aged 73.5 ± 9.5 years (PR group: 297 eyes, conventional group: 387 eyes). No intergroup differences were found in systolic blood pressure or pulse and heart rates; however, diastolic blood pressure was significantly lower in the PR group than in the conventional group at both the beginning and the end of surgery (P <.001 and P = .0028, respectively). Intravenous nicardipine administration in the operating room was significantly less frequent in the PR group (P = .041), and physician consultation time after entering the operating room and at the beginning of surgery was significantly shorter in the PR group (both P <.001).
Early monitoring of PR with blood pressure and intervention were effective for preventing preoperative hypertension.
很少有研究探讨白内障术前脉搏率波动的临床影响。本研究旨在确定术前脉搏监测和干预对预防局部麻醉下白内障手术患者血压变化的效果。
回顾性研究
纳入接受局部麻醉下白内障手术的患者。在脉搏率（PR）组中，根据血压和 PR 变化的早期监测进行干预。在常规组中，仅根据血压进行血压管理。回顾性比较两组之间的收缩压、舒张压、术中尼卡地平使用和医生咨询时间。
该研究纳入了 684 名 73.5±9.5 岁（PR 组：297 只眼，常规组：387 只眼）患者的 684 只眼。两组间收缩压或脉搏和心率无差异；然而，手术开始和结束时 PR 组的舒张压明显低于常规组（均 P<0.001 和 P=0.0028）。PR 组术中静脉尼卡地平的使用频率明显较低（P=0.041），PR 组进入手术室后和手术开始时的医生咨询时间明显缩短（均 P<0.001）。
血压和干预早期监测 PR 对预防术前高血压有效。
