[Prevention of hemodynamic disorders during anesthesia in middle-aged and elderly patients with essential hypertension. Components of anesthesia. II].
Hemodynamic parameters were evaluated during various stages of anesthesia in two groups of patients aged 60-85 years with mild essential hypertension. In group 1, routine preoperative treatment with hypotensive drugs was carried out and in group 2 differentiated preoperative treatment with calcium antagonists was carried out with consideration for a hemodynamic type. Group I patients were operated on under traditional neuroleptic analgesia (NLA), group 2 under NLA with 40% lower drug doses than in group 1 and with addition of calcium antagonists. To patients with hypo- and eukinetic hemodynamics, nifedipine was injected (bolus injection) in a dose of 14.2 micrograms/kg before induction and then was infused in a dose of 6.0-14.2 micrograms/kg/min. Patients with hyperkinetic hemodynamics were injected verapamil in a dose of 70-140 micrograms/kg (bolus injection) and then the same dose every hour of the operation. Differentiated use of calcium antagonists during anesthesia helped transform the hyper- and hypokinetic types of hemodynamics into a more rational eukinetic type, which was associated with a decrease of MVO2. Calcium antagonists, exerting analgesic, automatic stabilizing, and antihypoxic effects, prevented the hyperdynamic reactions complicating NLA in 30% cases and precluded complications of concomitant ischemic diseases, which were observed in 40% of group 1 patients.
Gur'ianov
V A
VA
Gologorskiĭ
V A
VA
Martynov
A N
AN
Eroshin
N I
NI
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology*; D004329:Droperidol / Q000008:administration & dosage; D005283:Fentanyl / Q000008:administration & dosage; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008875:Middle Aged; D009458:Neuroleptanalgesia / Q000379:methods*; D009543:Nifedipine / Q000008:administration & dosage / Q000494:pharmacology; D011300:Preoperative Care; D013997:Time Factors; D014700:Verapamil / Q000008:administration & dosage / Q000494:pharmacology
D000759:Adjuvants, Anesthesia; D002121:Calcium Channel Blockers; D014700:Verapamil; D009543:Nifedipine; D004329:Droperidol; D005283:Fentanyl
Profilaktika gemodinamicheskikh narusheniĭ vo vremia anestezii u bol'nykh pozhilogo i starcheskogo vozrasta s soputstvuiushcheĭ gipertonicheskoĭ bolezn'iu v svete komponentnosti anestezii (Chast' II).