24-HOUR BLOOD PRESSURE MONITORING PARAMETERS IN THE PERI-INTERVENTIONAL PERIOD AMONG PATIENTS WITH LAPAROSCOPIC CHOLECYSTECTOMY
Abstract
The study analysed the circadian blood pressure (BP) profile in patients with arterial hypertension (AH) before planned surgery, and also investigated the association between pre-surgery BP parameters and the risk of intra- and post-interventional complications. The study included 52 AH patients with cholelithiasis, admitted to a surgery department for a planned laparoscopic cholecystectomy. All participants underwent office BP measurement, as well as 24-hour BP monitoring (BPM) 2 weeks and 24 hours before the intervention. The incidence of peri-interventional complications was assessed. According to the 24-hour BMP results 2 weeks before the intervention, 50% of the patients had a normal circadian profile (“dipper”) of both systolic and diastolic BP (SBP, DBP). 24 hours before the intervention, pathological circadian SBP and DBP indices became more prevalent (mostly “non-dipper” type), and heart rate levels increased for both nighttime and daytime. Preinterventional AH features predicted the risk of peri-interventional complications. Therefore, pre-surgery 24-hour BPM can facilitate the identification of the patients with high risk of peri-interventional complications.
About the Authors
R. V. Repnikova
ГОУ ВПО Кемеровская государственная медицинская академия Росздрава, Кемерово
УРАМН Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний СО РАМН, Кемерово
Russian Federation
Russian Federation
O. I. Golofaeva
ГОУ ВПО Кемеровская государственная медицинская академия Росздрава, Кемерово
Russian Federation
Russian Federation
O. L. Barbarash
ГОУ ВПО Кемеровская государственная медицинская академия Росздрава, Кемерово
Russian Federation
Russian Federation
References
1. Барбараш О. Л., Шабалина Л. В., Берген Е. И. и др. Феномен предоперационного стресса у больных ИБС. Оценка его клинической и прогностической значимости//Тер. архив. – 1998. – № 12. – С. 31–35.
2. Нечаева Г. И. Нарушение гемодинамики и профилактика ишемических осложнений у больных артериальной гипертонией при лапароскопической холецистэктомии//Анестезиология и реаниматология. – 2006. – № 2. – С. 32–35.
3. Погосова Н. В. Стресс у кардиологических больных. Клинические аспекты влияния на прогноз и тактика врача общей практики в коррекции стресса//Сердце. – 2007. – № 6. – С. 310–315.
4. Самойленко В. В. Предоперационное обследование и подготовка к некардиологическим операциям пациентов с сердечно-сосудистыми заболеваниями//Сердце. – 2008. – Т. 7, № 2. – С. 99–107.
5. Тимошин А. Д., Шестаков А. Л., Барнаев А. Л. Непосредственные и отдаленные результаты лапароскопической холецистэктомии//Анналы хирургии. – 2006. – № 1. – С. 45–48.
6. Auerbach A. D., Goldman L. Assessing and reducing the cardiac risk of noncardiac surgery//Circulation. – 2006. – Vol. 113, № 10. – P. 1361–1376.
7. Brett A. Coronary assessment before noncardiac surgery current strategies are flaved//Circulation. – 2008. – Vol.117. – P.3145–3151.
8. Diamantis T., Tsigris C., Kiriakopoulos A. et al. Bile duct injuries Associated with Laparoscopic and Open Cholecystectomy: An 11-Year Experience in One Institute//Surg Today. – 2005. – Vol.35. – P.841–845.
9. Fleisher L. A., Beckman J. A., Brown K. A. et al. ACC/AHA 2007 Guidelines on preoperative cardiovascular evaluation and care for noncardiac surgery: executive summary//Circulation. – 2007. – Vol.116. – P.1971–1996.
10. Freeman W. K., Gibbons R. J. Perioperative Cardiovascular assessment of Patients Undergoing Noncardiac Surgery//Mayo Clin Proc. – 2009. – Vol.84, № 1. – P.79–90.
11. Maddox T. M. Preoperative Cardiovascular Evaluation for Noncardiac Surgery. The Mount Sinai//Journal of Medicine. – 2005. – Vol.72, № 3. – P.185–192.
12. Poldermans D., Bax J. J., Boersma E. et al. Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery, European Society of Cardiology; European Society of Anaesthesiology//Eur Heart J. – 2009. – Vol.30. – P.2769–2812.
Review
For citations:
Repnikova R.V., Golofaeva O.I., Barbarash O.L. 24-HOUR BLOOD PRESSURE MONITORING PARAMETERS IN THE PERI-INTERVENTIONAL PERIOD AMONG PATIENTS WITH LAPAROSCOPIC CHOLECYSTECTOMY. Russian Journal of Cardiology. 2011;(6):31-37. (In Russ.)
Views:
592
Email this article 