engleski

More hemodynamic changes in hypertensive versus non-hypertensive patients undergoing breast cancer surgery in general anesthesia : a prospective clinical study

Preoperative comorbidity may significantly influence theconduction of anesthesia and patients’ outcome. The aim of this study was to compare a number of anesthetic interventions and the use of non-anesthetic drugs in hypertensive and non-hypertensivepatients during general anesthesia for moderately invasive surgery. A total number of 88 elective hypertensive (n = 44) andnon-hypertensive (n = 44) breast cancer patients were enrolled inthe prospective study. Midazolam and infusion of normal salinewere given before anesthesia. Etomidate, rocuronium, fentanyl, and sevoflurane up to the 1 MAC were used for the maintenanceof anesthesia. Mean arterial pressure (MAP), pulse, core temperatureand intraoperative use of all drugs were recorded. MAP was maintained by sevoflurane and infusion replacement. Urapidil and ethylephrine were given if MAP differed > or <30% of baseline, and atropine if heart rate <50 beats min-1. A statistical analysis was made using chi-square and Mann-Whitney tests. The highest MAP was 133± ; ; 19.3 in hypertensive and 122± ; ; 16.5mmHg in the non-hypertensive patients (p<0.05). Hypertensive patientsrequired more anesthetic balancing (42 vs. 23 interventions), more urapidil for intraoperative hypertension (13/44 vs. 2/44, p<0.05) and had more intraoperative hypotensive episodes (23 vs. 12 ; ns, p> 0.05). Intraoperative bradycardia (11/44 vs.7/44) and atropine applications (16 vs. 9, ns, p> 0.05) were similar in two groups. Conclusion Hypertensive patients required more anesthetic interventionsand had higher consumption of vasoactive drugs duringanesthesia for breast cancer surgery, suggesting their hemodynamicinstability possibly related to the hypertension.

hypertension ; cardiovascular agents ; ganglionic blockers ; sympatomimetics ; general anesthesia ; breast cancer

Rad je djelomicno prezentiran na skupu Euroanaesthesia 2008, Kopenhagen, Danska.