Boyle M, Hundy S, Torda T A
Prince Henry Hospital, Little Bay, New South Wales.
Aust Crit Care. 1997 Dec;10(4):120-2. doi: 10.1016/s1036-7314(97)70414-4.
An association between the administration of paracetamol and relative hypotension in critically ill intensive care patients has been reported anecdotally by nursing staff working in the Intensive Care Unit (ICU) of Prince Henry Hospital. An observational study was therefore undertaken, to determine whether there is a temporal association between the administration of paracetamol and changes in blood pressure. A dose of 1 gram of paracetamol was administered orally or by feeding tube. Blood pressure was recorded 30 minutes prior to paracetamol administration, at the time of administration and then at 15-minute intervals for the first hour and at half-hour intervals for the second hour after administration. Analysis of data from 37 individuals using a repeated measures ANOVA showed that systolic arterial pressure (SAP) and mean arterial pressure (MAP) were reduced significantly over the observation period (p < 0.0001 for both). SAP and MAP fell by an average of approximately 10 and 7 per cent respectively, with maximum falls of 36 and 34 per cent respectively. Paracetamol administration may be indicated for the control of fever in critically ill patients, thereby reducing oxygen demand. However, this must be balanced against the possibility of causing a significant fall in blood pressure.
亨利王子医院重症监护病房（ICU）的护理人员曾有过轶事报道，称在重症监护患者中，对乙酰氨基酚的使用与相对性低血压之间存在关联。因此，开展了一项观察性研究，以确定对乙酰氨基酚的使用与血压变化之间是否存在时间上的关联。口服或通过喂食管给予1克对乙酰氨基酚。在给予对乙酰氨基酚前30分钟、给药时以及给药后的第一小时每隔15分钟、第二小时每隔30分钟记录血压。对37名个体的数据进行重复测量方差分析显示，在观察期内收缩动脉压（SAP）和平均动脉压（MAP）显著降低（两者p均<0.0001）。SAP和MAP平均分别下降约10%和7%，最大降幅分别为36%和34%。对乙酰氨基酚可用于控制重症患者的发热，从而降低氧需求。然而，这必须与导致血压显著下降的可能性相权衡。
