Original scientific paper

https://doi.org/10.20471/acc.2023.62.04.5

Prediktori intraoperacijske hipertenzije u kirurgiji vrata: retrospektivno istraživanje u jednom centru

Tjaša Ivošević ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Belgrade, Serbia *
Biljana Miličić ; Department of Medical Statistics and Informatics, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
Aleksandar Trivić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Bojana Bukurov ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Nenad Arsović ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Nikola Slijepčević ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Hristina Ugrinović ; Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Belgrade, Serbia
Nemanja Radivojević ; Hospital for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Belgrade, Serbia
Nevena Kalezić ; Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Belgrade, Serbia

* Corresponding author.

Abstract

Intraoperacijska hipertenzija (IOHTA) nije poželjna u kirurgiji vrata, jer kod ove vrste kirurgije postoji naročita sklonost
ka krvarenju i u normotenzivnoj anesteziji. Cilj naše studije bio je utvrditi incidenciju i čimbenike rizika za pojavu IOHTA
kod bolesnika podvrgnutih kirurgiji vrata. Ova retrospektivna studija je obuhvatila 880 odraslih bolesnika koji su u općoj
anesteziji bili podvrgnuti kirurgiji vrata. Ispitivali smo utjecaj spola, dobi, supostojećih bolesti, otežane intubacije traheje,
trajanja anestezije i inducirane hipotenzije na pojavu IOHTA. IOHTA je zabilježena kod 57 (6,7%) bolesnika. Bolesnici s
ASA statusom 4 i oni s Cormack-Lehaneovim stupnjem 4 najčešće su imali IOHTA (22,2% odnosno 21,4%). Značajno više
bolesnika s hipertenzijom, hiperlipoproteinemijom i ventrikulskim ekstrasistolama je imalo IOHTA u odnosu na bolesnike
bez ovih subolesti. Značajni prediktori IOHTA bili su dob (OR 1,438; 95% CI 1,144-1,808; p=0,002), srčana aritmija (OR
1,702; 95% CI 1,129-2,566; p=0,011), Cormack-Lehaneov stupanj (OR 1,407; 95% CI 1,054-1,878; p=0,020), trajanje
anestezije (OR 1,005; 95% CI 1,001-1,008; p=0,005). Rizik za pojavu IOHTA je bio manji u bolesnika s induciranom hipotenzijom
(OR 0,024; 95% CI 0,003-0,185; p=0,000). Tijekom kirurgije vrata naročitu pozornost treba obratiti bolesnicima
starije životne dobi, bolesnicima sa srčanom aritmijom, otežanom intubacijom i dužim trajanjem anestezije, jer su oni pod
povećanim rizikom od razvoja IOHTA.

Keywords

Hipertenzija; Intraoperacijsko razdoblje

Hrčak ID:

320268

URI

https://hrcak.srce.hr/320268

Publication date:

31.12.2023.

Article data in other languages: english

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