Department of Anesthesiology, The Second Affiliated Hospital of Zunyi Medical University, ZunYi, GuiZhou, China.
Department of Ultrasound, The Second Affiliated Hospital of Zunyi Medical University, ZunYi, GuiZhou, China.
J Clin Anesth. 2024 Dec;99:111646. doi: 10.1016/j.jclinane.2024.111646. Epub 2024 Oct 9.
Limited literature exists on the vascular reactivity of the radial and ulnar arteries in hypertensive patients following radial artery cannulation. This study assessed the vascular reactivity of the radial and ulnar arteries by comparing Doppler images and laser speckle contrast imaging (LSCI) obtained from both normotensive and hypertensive patients after radial artery cannulation under general anesthesia.
This study recruited 99 normotensive and 99 hypertensive patients who required arterial cannulation under general anesthesia. In the course of research, to evaluate the impact of hypertension on arterial reactivity, we employed duplex Doppler ultrasonography to measure the inner diameter (ID), resistance index (RI) and mean volume flow (MVF) of both arteries at five different time points. We equally performed perfusion of thumb and little finger by laser speckle contrast imaging.
After radial artery cannulation, the hypertensive group showed less increase in radial ID and less decrease in RI compared to the normotensive group. The MVF increase was also less pronounced in hypertensive patients, while both groups demonstrated equivalent ulnar ID changes, and the normotensive group exhibited a more significant decrease in RI and a greater MVF increase. Thumb perfusion decreased post-cannulation in both groups, with the hypertensive group showing a less robust recovery. Little finger perfusion increased after artery cannulation in both groups, but the hypertensive group's increase was lower. The incidence of vasospasm in the hypertensive group is higher than that in the normotensive group.
The radial and ulnar arteries in hypertensive patients may lack a compensatory response to radial artery cannulation during general anesthesia.
在桡动脉置管后高血压患者的桡动脉和尺动脉的血管反应性的相关文献有限。本研究通过比较桡动脉置管后全麻下的正常血压患者和高血压患者的多普勒图像和激光散斑对比成像（LSCI），评估桡动脉和尺动脉的血管反应性。
本研究招募了 99 名正常血压和 99 名高血压患者，这些患者在全麻下需要进行动脉置管。在研究过程中，为了评估高血压对动脉反应性的影响，我们使用双功能多普勒超声测量了 5 个不同时间点两支动脉的内径（ID）、阻力指数（RI）和平均体积流量（MVF）。我们同样通过激光散斑对比成像对拇指和小指进行灌注。
桡动脉置管后，与正常血压组相比，高血压组桡动脉 ID 的增加较少，RI 的降低较少。高血压患者的 MVF 增加也不明显，而两组的尺动脉 ID 变化相同，正常血压组的 RI 降低更明显，MVF 增加更大。两组拇指灌注均在置管后减少，高血压组恢复程度较差。两组小指灌注在置管后均增加，但高血压组增加幅度较低。高血压组的血管痉挛发生率高于正常血压组。
在全麻期间，高血压患者的桡动脉和尺动脉可能缺乏对桡动脉置管的代偿反应。
