Comparison of the effect of different doses of phenylephrine infusion on the prevention of hypotension in the elderly under spinal anaesthesia in orthopaedic surgery.

IF 1.2 Q3 SURGERY

Journal of perioperative practice Pub Date : 2024-10-08 DOI:10.1177/17504589241274470

Mitra Golmohammadi, Shahryar Sane, Wesam R Kadhum, Ahmed Hjazi, Mohammed N Fenjan, Farnaz Mahmoudifar, Behzad Kazemi Haki, Mehri Soodagar Eskandarabadi, Somayeh Ghavipanjeh Rezaiy

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引用次数: 0

Abstract

Background: Considering the vasopressor drug categories and doses that can be used for elderly patients following hypotension are few, the present trial aimed to compare the effect of different doses of phenylephrine infusion on the prevention of hypotension in elderly patients undergoing orthopaedic lower extremities surgery.

Methods: This randomised, double-blind prospective clinical trial was conducted by including 60 elderly patients older than 60 years and classified as American Society of Anesthesiology class I and II who were candidates for femur fracture fixation surgery. White and black cards randomly allocated patients to: group A (25µg/kg/h phenylephrine) or group B (35µg/kg/h phenylephrine).

Results: At the T₃-T₇ time points, group A's systolic and diastolic blood pressure was significantly higher than in group B's (p < 0.05). However, after 27 minutes (T₀-T₇) of phenylephrine infusion, statistical analysis showed no significant difference between the two groups regarding blood pressure (T₈-T_end). The frequency of bradycardia and reactive hypertension in group B were significantly higher than in group A (p = 0.02) and (p = 0.03), respectively. There was no significant difference between the bleeding loss, blood transfusion and crystalloid volume in both groups (p > 0.05).

Conclusion: Our trial illustrated that high-dose phenylephrine infusion could not assure haemodynamic stability and may cause some side effects.

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比较不同剂量的苯肾上腺素输注对预防骨科手术脊髓麻醉中老年人低血压的效果。

背景：考虑到可用于老年低血压患者的血管加压药物种类和剂量较少，本试验旨在比较输注不同剂量的苯肾上腺素对老年下肢骨科手术患者预防低血压的效果：这项随机双盲前瞻性临床试验纳入了 60 名年龄在 60 岁以上、美国麻醉学会分级为 I 级和 II 级的股骨骨折固定手术老年患者。白卡和黑卡将患者随机分配到 A 组（25µg/kg/h 苯肾上腺素）或 B 组（35µg/kg/h 苯肾上腺素）：在T3-T7时间点，A组的收缩压和舒张压明显高于B组（P 0-T7），统计分析显示两组血压（T8-Tend）无明显差异。B 组出现心动过缓和反应性高血压的频率分别明显高于 A 组（P = 0.02）和（P = 0.03）。两组的失血量、输血量和晶体液量无明显差异（P > 0.05）：结论：我们的试验表明，大剂量输注苯肾上腺素不能保证血流动力学稳定，而且可能会引起一些副作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of perioperative practice Nursing-Medical and Surgical Nursing

CiteScore

1.60

自引率

0.00%

发文量

期刊介绍： The Journal of Perioperative Practice (JPP) is the official journal of the Association for Perioperative Practice (AfPP). It is an international, peer reviewed journal with a multidisciplinary ethos across all aspects of perioperative care. The overall aim of the journal is to improve patient safety through informing and developing practice. It is an informative professional journal which provides current evidence-based practice, clinical, management and educational developments for practitioners working in the perioperative environment. The journal promotes perioperative practice by publishing clinical research-based articles, literature reviews, topical discussions, advice on clinical issues, current news items and product information.