Dolina O A, Gur'ianov V A, Tiukov V L, Efremushkina O D
Anesteziol Reanimatol. 1996 Jan-Feb(1):4-6.
Clonidine in a dose of 2.5 to 3 mg/kg was used as a component of anesthesia in 150 patients aged 60 to 85. Essential hypertension of the second-third stages was diagnosed in 57% patients (group 1), systolic sclerotic arterial hypertension (SSAH) in 43% (group 2). Anesthesia was characterized by stable hemodynamics; however, analysis within the groups showed an increase of systolic and diastolic arterial pressure in 40% patients in group 2. There were no clinical signs of inadequacy of anesthesia. Remembering about the reduction of the reserve potential of the cardiovascular system in this cohort of patients, neurovegetative inhibition was supplemented by peripheral a-adrenoblocker droperidol, starting from the test dose of 1.25 and increasing it to 5 mg over the course of anesthesia; this led to stabilization of the peripheral and improvement of the central hemodynamics. Differences in the changes of central hemodynamics may be explained by specific features of circulation in patients with essential hypertension and SSAH, as well as by a higher tone of the sympathetic component of the CNS in SSAH patients.
在150名60至85岁的患者中，使用剂量为2.5至3毫克/千克的可乐定作为麻醉的一个组成部分。57%的患者被诊断为二至三期原发性高血压（第1组），43%的患者为收缩期硬化性动脉高血压（SSAH，第2组）。麻醉的特点是血流动力学稳定；然而，组内分析显示第2组40%的患者收缩压和舒张压升高。没有麻醉不足的临床迹象。考虑到该组患者心血管系统储备潜力的降低，从1.25毫克的试验剂量开始，在麻醉过程中将外周α-肾上腺素能阻滞剂氟哌利多增加至5毫克，以补充神经植物性抑制；这导致外周血流动力学稳定并改善了中心血流动力学。中心血流动力学变化的差异可能由原发性高血压和SSAH患者循环的特定特征以及SSAH患者中枢神经系统交感神经成分的较高张力来解释。
