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首页> 外文期刊>The Open Anesthesia Journal >Assessment of Haemodynamic Response to Induction of General Anaesthesia in Healthy Adult Patients Undergoing Elective Orthopaedic Surgery by Using a Continuous Non-invasive Cardiovascular Monitoring
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Assessment of Haemodynamic Response to Induction of General Anaesthesia in Healthy Adult Patients Undergoing Elective Orthopaedic Surgery by Using a Continuous Non-invasive Cardiovascular Monitoring

机译：使用连续性非侵入性心血管监测评估健康成人接受择期整形外科手术的全麻患者的血液动力学反应

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Background:Continuous cardiovascular monitoring as part of management of high-risk surgical patients is widely practiced, however the role of continuous monitoring as part of routine management in low-risk surgical patients is unclear. Our aim was to investigate haemodynamic and Bispectral Index (BIS) changes in healthy patients undergoing surgery following induction of anaesthesia with propofol using a continuous non-invasive blood pressure device (LiDCO rapid?). We sought to obtain detailed monitoring of cardiovascular parameters from the pre-induction stage.Methods:This prospective, observational single-centre study was conducted at a London teaching hospital between June-November 2014. Patients aged between 18-45 years, American Society of Anesthesiologists grade I-II undergoing elective lower-limb arthroscopic procedures were included. Variables including heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), cardiac output (CO), systemic vascular resistance (SVR) and BIS were recorded continuously prior to induction and up to 3-minutes after.Results:The following relative haemodynamic changes were noted between baseline and 1-minute post-induction with propofol: CO +15.2%, HR +10.1%, SVR -22.9% and MAP -10.1% (p<0.001 for each parameter). There was a mean change of: HR -10.1%, CO -14% and MAP -18.0%(p<0.001 for each parameter) between baseline and 3-minutes post-induction. Median change of BIS was -61.7% (p<0.001) between baseline and 3-minutes post-induction. Significant, positive correlations were noted between MAP and BIS at 30-seconds (r=0.60, p<0.001) and 1-minute post-induction (r=0.61, p<0.001).Conclusion:Our study shows that healthy patients undergoing continuous minimally invasive orthopaedic surgery experience significant haemodynamic and BIS changes following induction of anaesthesia. Our findings highlight the importance of baseline cardiovascular and BIS monitoring as part of routine perioperative management.
机译：背景：作为高危外科手术患者管理的一部分，持续进行心血管监护已得到广泛实践，但是对于低危外科手术患者，作为日常管理的一部分进行连续监护的作用尚不清楚。我们的目的是研究使用连续无创血压仪（LiDCO fast？）用异丙酚诱导麻醉后接受手术麻醉的健康患者的血流动力学和双谱指数（BIS）的变化。我们寻求在诱导前阶段进行详细的心血管参数监测。方法：这项前瞻性，观察性单中心研究于2014年6月至11月在伦敦的一家教学医院进行。年龄在18-45岁之间的患者，美国包括接受选择性下肢关节镜手术的I-II级麻醉师。在诱导之前和之后的3分钟内连续记录变量，包括心率（HR），平均动脉压（MAP），中风量（SV），心输出量（CO），全身血管阻力（SVR）和BIS。 ：在基线和异丙酚诱导后1分钟之间，注意到以下相对血液动力学变化：CO + 15.2％，HR + 10.1％，SVR -22.9％和MAP -10.1％（每个参数p <0.001）。在基线和诱导后3分钟之间，HR -10.1％，CO -14％和MAP -18.0％的平均变化（每个参数p <0.001）。在基线和诱导后3分钟之间，BIS的中位变化为-61.7％（p <0.001）。结论：我们的研究表明，健康的患者在连续30秒（r = 0.60，p <0.001）和诱导后1分钟（r = 0.61，p <0.001）之间存在显着的正相关。微创骨科手术在麻醉后会出现明显的血流动力学和BIS变化。我们的研究结果突显了基线心血管和BIS监测作为常规围手术期管理的一部分的重要性。

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