加齢は麻酔管理に影響を及ぼすか--術中循環系イベントの発生および術前合併症との関連性についての臨床的検討
スポンサーリンク
概要
- 論文の詳細を見る
Clinical data of 1956 anesthetic cases older than 40 years in 2001 were analized retrospectively on preoperative complications, anesthetic methods and intraoperative complications in order to examine the influence of age on anesthetic management. The cases undergoing cardiac surgery and obstetric anesthesia and those which used an artificial heart-lung were excluded from this study. The patients were divided into 5 groups according to age: Group 1 (40-49 years), Group 2 (50-59 years), Group 3 (60-69 years), Group 4 (70-79 years), and Group 5 (80 or older) . These 5 groups were subsequently divided into 3 groups according to method of anesthesia: general anesthesia (GA), combined epidural-general anesthesia (CEGA), and spinal anesthesia (SA) . The results were as follows: The preoperative complications were significantly increased in elderly patients, especially those with hypertension, ECG change and cardiac disease. The incidence rate of intraoperative hypertension above 180 mmHg was higher in the GA group than in the CEGA group. Intraoperative hypertension had a slight correlation with preoperative hypertension. The incidence rate of intraoperative hypotension under 80 mmHg was the highest in the CEGA group. Intraoperative hypotension showed a slight correlation with preoperative ECG change. The cases treated with vasopressor were most frequently observed in the CEGA group. In particular, a majority of over 60's needed treatments with vasopressor. The incidence rate of intraoperative blood transfusion was high in the GA and the CEGA groups. This clinical study revealed that preoperative complications and incidences of intraoperative hemodynamic disorder significantly increase in elderly patients. Geriatric anesthesia requires very skillful management of the vasopressor and anesthetic agents.
- 昭和大学・昭和医学会の論文