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ISSN 2078-7170 (Electronic)

2011, Number 3

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CorSalud 2011; 3 (3)

Anesthetic management in hypertensive patients in urgent need of surgery

González MM, Sunderland TN, García CS

Language: Spanish
References: 51
Page: 134-148
PDF size: 270.03 Kb.


ABSTRACT

Introduction and Objectives: The increase in hypertension in recent years has had an effect on the large number of hypertensive surgical patients scheduled for emergency surgery. The purpose of this research was to implement a protocol for the treatment and control of hypertensive patients in this type of surgery. Method: A comparative study in hypertensive patients scheduled for emergency surgery was designed. 100 patients, divided into two groups were studied. Group I, consisted of patients who received 25 mg of sublingual captopril, 30 minutes before the surgical procedure, and Group II, was formed by those who did not receive it. The response variables were systolic and diastolic blood pressures and heart rate on arrival in the operating room and during surgery. Results: There was a greater perioperative hemodynamic stability in group I. Intraoperative complications appeared in 30 % of patients in the first group and in 66 % in the second group. In the postoperative period, 26 % of patients had complications in group I and 52% in group II. These differences were statistically significant p ‹ 0,05. Conclusions: the advantages, benefits and hemodynamic stability were demonstrated, when hypertensive patients, scheduled for emergency surgery, come to the operating room with high blood pressure, and sublingual captopril is administered 30 minutes before surgery.


REFERENCES

  1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The National High Blood Pressure Education Program Coordinating Committee. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-52.

  2. Ramírez Méndez M, Moreno-Martínez FL, Torres Ruiz D, Nieto Monteagudo CG, Osorio Gómez CM, Guevara González A, et al. Detección de hipertrofia ventricular izquierda en adolescentes con hipertensión arterial esencial. Hipertensión (Madrid). 2006;23(9):277-83.

  3. Ogunlewe MO, James O, Ajuluchukwu JN, Ladeinde AL, Adeyemo WL, Gbotolorun OM. Evaluation of haemodynamic changes in hypertensive patients during tooth extraction under local anaesthesia. West Indian Med J. 2011;60(1):91-5.

  4. Harrison’s H. Principles of Internal Medicine. 14th ed. New York: Edit Mc Graw-Hill; 1997.

  5. Lucky D, Turner B, Hall M, Lefaver S, de Werk A. Blood pressure screenings through community nursing health fairs: motivating individuals to seek health care follow-up. J Community Health Nurs. 2011;28(3):119-29.

  6. Culig J, Leppée M, Boskovic J, Eric M. Determining the difference in medication compliance between the general patient population and patients receiving antihypertensive therapy: A case study. Arch Pharm Res. 2011;34(7):1143-52.

  7. Wax DB, Porter SB, Lin HM, Hossain S, Reich DL. Association of preanesthesia hypertension with adverse outcomes. J Cardiothorac Vasc Anesth. 2010;24(6):927-30.

  8. Singh R, Choudhury M, Kapoor PM, Kiran U. A randomized trial of anesthetic induction agents in patients with coronary artery disease and left ventricular dysfunction. Ann Card Anaesth. 2010; 13(3):217-23.

  9. Dávila CE. Evaluación preoperatoria del paciente quirúrgico. En: Dávila CE, Gómez BC, Álvarez B I, Sainz CH, Molina L R M. Anestesiología Clínica. Rodas: Damuji; 2001. p 61-9.

  10. Comisión Nacional de Hipertensión Arterial. Programa nacional de prevención, diagnóstico, evaluación y control de la hipertensión arterial. La Habana: MINSAP; 1998.

  11. Varón J, Polansky M. Crisis hipertensiva: Diagnóstico y tratamiento [Internet]. 2003 [citado 13 Nov de 2005]. Disponible en: http://www.uam.es/departamentos/medicina/anesn et/revistas/ijae/vol1n1e/articulos/htncrise.htm

  12. Pérez Olea J. Historia de la hipertensión [Internet]. 2003 [citado 13 Nov de 2005]. Disponible en: http://www2.udec.cl/~ofem/revista/revista02/revista 1.html

  13. Ferreira SH. History of the development of inhibitors of angiotensin I conversion. Drugs. 1985;30 (Suppl-1):1-5.

  14. Unger T, Gohlke P. Converting enzyme inhibitors in cardiovascular therapy: current status and future potential. Cardiovasc Res. 1994;28(2):146-58.

  15. Padfield PL, Beeneis DG, Brown JJ. Is low renin hypertension a stage in the development of essential hypertension or a diagnostic entity? Lancet. 1995;1:548-50.

  16. Tocci G, Volpe M. Fixed-combination therapy to improve blood pressure control: experience with olmesartan-based therapy. Expert Rev Cardiovasc Ther. 2011;9(7):829-40.

  17. Erie AJ, McHugh R, Warner M, Erie JC. Model of anesthesia care that combines anesthesiologists and registered nurses during cataract surgery. J Cataract Refract Surg. 2011;37(3):481-5.

  18. Rolla A. Resistencia insulínica. Av Diabetol. 1994; 8:13-36.

  19. Toruncha A, García D. Interacción de los inhibidores de la enzima conversora de angiotensina con otros medicamentos. Arch Dom Hipertens. 2001;1:39-40.

  20. Coca A, De la Sierra A. Hipertensión arterial y riesgo cardiovascular. Jano especial 2000;58 (1344):40-44.

  21. Dickerson L M, Gibson MV. Management of hypertension in older person. American Farm Physician J 2005; 71(3):469-476.

  22. Arauz P C, Parrott M A, Raskin P. The treatment of hypertension in adult patients with diabetes (Technical Review). Diabetes Care. 2002;25:134-47.

  23. The American Diabetes Association. Treatment of Hypertension in Adults with Diabetes. Diabetes Care. 2003;26:S80-S82.

  24. Ministerio de Salud Pública de Cuba. Información sobre pacientes dispensarizados y población de Cuba [Internet]. 2005. [citado 2 Oct 2005]. Disponible en: www.sld.cu/servicios/hta

  25. Martín JC, Simal F, Carretero AL, Bellido J, Arzúa M, Mena FJ, et al. Prevalencia grado de detección, tratamiento y control de la hipertensión arterial en población general. Estudio Hortega. Hipertensión. 2003;20(4):148-154.

  26. Williams B, Poulter N R, Brown M J, Davis M, Mc. lnnes G T, Potter J F, et al. Guidelines for management of hypertension. J Hypertension. 2004;18: 139-85.

  27. Comfere T, Sprung J, Kumar M M, Draper M, Wilson D P, Williams B A, et al. Angiotensin System Inhibitors in a General Surgical population. Anesth Analg. 2005;100(3):636-44.

  28. Luna OP, Holler U. Hipertensión Arterial sistémica. En: Luna Ortiz P. Anestesia en el cardiópata. 2da ed. México: Mc Graw- Hill Interamericana editores; 2002. p. 117-23

  29. Campbell NR, Gilbert RE, Leiter LA, Larochelle P, Tobe S, Chockalingam A, et al. Hypertension in people with type 2 diabetes: Update on pharmacologic management. Can Fam Physician. 2011; 57(9):997-1002..

  30. Putnam W, Lawson B, Buhariwalla F, Goodfellow M, Goodine RA, Hall J, et al. Hypertension and type 2 diabetes: What family physicians can do to improve control of blood pressure - an observational study. BMC Fam Pract. 2011 Aug 11;12:86.

  31. Gu W, Pagel PS, Warltier DC, Kersten JR. Modifying cardiovascular risk in diabetes Mellitus. Anesthesiology. 2003;98(3):774-9.

  32. Guía española de hipertensión arterial. Tratamiento de la hipertensión arterial en situaciones especiales. Hipertensión. 2005; 22(Supl. 2):58-69.

  33. Grupo de redacción de la organización mundial de la salud y Sociedad internacional de Hipertensión. Declaración 2003 de la OMS/ SIH sobre el manejo de la Hipertensión. J Hypertension. 2003;21:1983- 92.

  34. Paladino M A, Scheffelaar K. El paciente hipertenso y la anestesia. Anesth Analg Reanim. 2003; 18(1):45-56.

  35. Guía española de hipertensión arterial. Capitulo VIII. Tratamiento Farmacológico. Hipertensión. 2005;22( Supl. 2) :47-57.

  36. Giner GV, Esteban G, Corner G, Redón J. Tratamiento farmacológico combinado en el manejo de la hipertensión arterial crónica esencial. Hipertensión. 2004;21(3):139-57.

  37. Scafati LAJ. El paciente con hipertensión arterial sistémica y el anestesiólogo. III Congreso virtual mexicano de anestesiología [Internet]. México: Consejo Mexicano de Anestesiología; 2005 [citado 24 Nov 2004]. Disponible en: http://www.congresovirtual.com.mx/aula.pht?curid= 24

  38. Sociedad Española de Hipertensión. Estrés e hipertensión. Hipertensión. 2004; 30:35-45.

  39. Borroto GM, González MM, Veloz GI, De la Paz GME. Tratamiento farmacológico de la hipertensión arterial, implicaciones para el anestesiólogo. MediCiego [Internet]. 2007 [citado 14 Nov 2010];13 (Supl. 1). Disponible en: http://bvs.sld.cu/revistas/mciego/vol13_supl1_07/re visiones/r1_v13_supl107.html

  40. Desborough JP. The stress response to trauma and surgery. Br J Anaesth. 2000; 85(1):109-117.

  41. Dulanto Zabala D. Antihipertensivos y anestesia: problemas específicos. Rev Mex Anest. 2006;29 (Supl. 1):30-2.

  42. Singh A, Antognini JF. Perioperative hypotension and myocardial ischemia: diagnostic and therapeutic approaches. Ann Card Anaesth. 2011;14(2): 127-32.

  43. Vaquero LM, González J, Villoria M. Hipotensión refractaria durante la anestesia a una paciente en tratamiento con antagonistas de los receptores de la angiotensina. Rev Esp Anestesiol Reanim. 2004;51(6):338-41.

  44. Benigni A, Morigi M, Rizzo P, Gagliardini E, Rota C, Abbate M, et al. Inhibiting Angiotensin-converting enzyme promotes renal repair by limiting progenitor cell proliferation and restoring the glomerular architecture. Am J Pathol. 2011;179(2):628- 38.

  45. Ramírez F, Bandersky M, Larurfo P, Reyes AZ, Villamil A, García D, et al. Consenso latinoamericano sobre hipertensión arterial. J Hypertension. 2001;6(2):1-28.

  46. Eringa EC. To PRESERVE and protect: targeting the microcirculation in prevention of diabetes and its complications. J Hypertens. 2011;29(10):1859- 60.

  47. Chen G, Hemmelgarn B, Alhaider S, Quan H, Campbell N, Rabi D. Meta-analysis of adverse cardiovascular outcomes associated with antecedent hypertension after myocardial infarction. Am J Cardiol. 2009;104(1):141-7.

  48. Bugedo G. Alteraciones cardiovasculares y respiratorias frecuentes en el postoperatorio [Internet]. Chile: Facultad de medicina : Pontificia Universidad católica de Chile; 2002 [citado 23 Nov 2005]. Disponible en: http://escuela.med.puc.cl/paginas/departamentos/i ntensivo/articles/papers/alt.resp.CV.htm

  49. Paix AD, Runciman WB, Horan BF, Chapman M J, Currie M. Crisis management during anaesthesia: hypertension. J Hypertension. 2005;14(3):9-12.

  50. Sladen RN. Perioperative hypertension: What's new and what's useful? IARS 2002, Review Course Lectures. Anesthesia & Analgesia [Internet]. 2002 [citado 15 Nov 2010];(Suppl):[aprox. 4 p.]. Disponible en: http://www.cucrash.com/Handouts09/Sladen%20P erioperative%20HTN%202002.pdf

  51. Fornet I, Ortiz-Gómez JR, Palacio FJ, López MA. Uso de la nitroglicerina para facilitar la realización de diferentes técnicas anestésicas. Rev Esp Anestesiol Reanim. 2008;55(8):520-1.




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