Hahn R G
Department of Anaesthesiology, Huddinge University Hospital, Sweden.
Eur J Anaesthesiol. 1993 May;10(3):219-25.
An analysis was made of the development of hypotension in the course of 60 transurethral resections of the prostate (TURP) performed under epidural anaesthesia. Hypotension was defined as a decrease in the systolic pressure down to 85 mmHg or less, or a total drop of 60 mmHg or more within 15 min. Indirect estimations of the blood volume according to the haemoglobin dilution method indicated that patients who developed hypotension from the epidural anaesthesia had a larger decrease in blood volume than other patients. During the operation, hypotension was associated with a blood volume of 300 ml or more below baseline, while 400 ml above baseline was required to ensure a stable circulation when the legs were lowered and removed from the stirrups after the TURP. Low central venous pressures, which were measured in 30 of the patients, were also associated with hypotension during and after TURP. There was a significant linear relationship between the total changes in blood volume and CVP measured at the end of each 10-min period of TURP (P < 0.001). However, no correlation between heart rate and hypotension was found.
对60例在硬膜外麻醉下进行经尿道前列腺切除术（TURP）过程中低血压的发生情况进行了分析。低血压定义为收缩压降至85 mmHg或更低，或在15分钟内总下降60 mmHg或更多。根据血红蛋白稀释法对血容量进行的间接估计表明，因硬膜外麻醉发生低血压的患者血容量下降幅度大于其他患者。手术过程中，低血压与血容量比基线低300 ml或更多相关，而TURP后当腿部从马镫上放下并移出时，需要比基线高400 ml的血容量才能确保循环稳定。在30例患者中测量的中心静脉压较低，这也与TURP期间及术后的低血压相关。在TURP每10分钟时段结束时测量的血容量总变化与中心静脉压之间存在显著的线性关系（P < 0.001）。然而，未发现心率与低血压之间存在相关性。
