title: Associations between blood pressure responses to acute stress and impaired renal function and serum uric acid level.
abstract: The study aimed to examine correlations between blood pressure (BP) responses to direct laryngoscopy and tracheal intubation and parameters of renal function, serum uric acid (SUA) level, and mean preoperative BP. Fifty-four patients (≥ 40 years) who were scheduled for oral surgery were analyzed. General anesthesia was induced by the rapid sequence method without opioid analgesics. Systolic and diastolic BP (SBP, DBP) in the operation room were measured when an electrocardiogram, a BP cuff, and a pulse oximetry probe were attached to the patients (T1) and immediately after the trachea was intubated (T2). The ΔSBP was defined as the difference between SBP at T2 and T1. The increasing rate of SBP (ΔSBPr) was defined as ΔSBP/SBP at T1. SBP at T2 was associated with increasing age (R = 0.44), serum creatinine (R = 0.32), SUA (R = 0.30), mean preoperative SBP and DBP (R = 0.54 and 0.37, respectively), and reduced estimated glomerular filtration rate (eGFR) (R = -0.44). Serum creatinine and SUA were positively associated, and eGFR was negatively associated with ΔSBP (R = 0.36, 0.34, and -0.29) and ΔSBPr (R = 0.39, 0.37, and -0.29). Multivariate regression analysis revealed that age and mean preoperative SBP was independently associated with SBP at T2, and serum creatinine was independently associated with ΔSBP and ΔSBPr. These findings suggested that elevated serum creatinine level, as well as elevated preoperative BP level, was associated with enhanced BP responses to acute stress in middle-aged to elderly patients.
authors.affiliation: a Department of Dental Anesthesiology , Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences , Sakuragaoka , Kagoshima , Japan , and.
authors.forename: Sachi
authors.initials: S
authors.lastname: Ohno
authors.affiliation: b Department of Cardiovascular Medicine and Hypertension , Field of Cardiovascular and Respiratory Disorders, Kagoshima University Graduate School of Medical and Dental Sciences , Sakuragaoka , Kagoshima , Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.affiliation: a Department of Dental Anesthesiology , Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences , Sakuragaoka , Kagoshima , Japan , and.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kohjitani
authors.affiliation: a Department of Dental Anesthesiology , Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences , Sakuragaoka , Kagoshima , Japan , and.
authors.forename: Akina
authors.initials: A
authors.lastname: Tohya
authors.affiliation: b Department of Cardiovascular Medicine and Hypertension , Field of Cardiovascular and Respiratory Disorders, Kagoshima University Graduate School of Medical and Dental Sciences , Sakuragaoka , Kagoshima , Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ohishi
authors.affiliation: a Department of Dental Anesthesiology , Field of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences , Sakuragaoka , Kagoshima , Japan , and.
authors.forename: Kazuna
authors.initials: K
authors.lastname: Sugiyama
mesh_terms: D000208:Acute Disease; D001794:Blood Pressure / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D013315:Stress, Psychological / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid
keywords: Baroreflex sensitivity; blood pressure; endothelial dysfunction; hypertension; tracheal intubation