| Japanese |
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| Title | 術後異常血圧上昇への対策 |
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| Subtitle | 誌上シンポジウム 血管拡張療法-POB後を考える |
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| Authors | 劔物修, 田中亮 |
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| Authors(kana) | |
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| Organization | 北里大学医学部麻酔科 |
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| Journal | 循環制御 |
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| Volume | 2 |
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| Number | 1 |
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| Page | 27-33 |
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| Year/Month | 1981/ |
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| Article | 報告 |
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| Publisher | 日本循環制御研究会 |
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| Abstract | はじめに 近年, 高齢者人口の増加, 高齢者に対する手術適応の拡大, さらに若年者層における心血管系疾患の増加などから, 術前から高血圧症の既往を有する患者に麻酔を施行する機会が多くなってきている1,2）. 術中の異常な血圧上昇は患者の心循環系のバランスを乱すだけでなく, 手術に伴う出血の増加, 手術成績の良否にも影響するわけで, その予防や治療については種々の検討がなされている3〜6）. 手術終了後, 患者を回復室に収容した時点で異常な血圧上昇を経験することも決してまれではない7）, ここでは, 過去1年間に著者らが経験した術後に異常血圧上昇をきたした症例をretrospectiveに分析し, 最近の症例を紹介しながら, その対策について若干の文献的考察を加えて報告する. 1. 過去1年間の症例の検討 昭和54年1月から12月までの1年間に, 北里大学病院中央手術部において, 麻酔科が管理した全麻酔症例数は5,220例である. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | hypertension, postoperative, nitroglycerin, epidural anesthesia, β-blocker |
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| English |
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| Title | Therapeutic approach to immediate postoperative hypertension. |
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| Subtitle | |
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| Authors | Osamu Kemmotsu, Ryo Tanaka |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology, Kitasato University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 2 |
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| Number | 1 |
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| Page | 27-33 |
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| Year/Month | 1981/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Significant postoperative hypertension was obseved in 206 （3.9％） of 5220 anesthesia cases in one year. These patients had several readings of over 180mmHg systolic blood pressure in the recovery room. The mean age of hypertensive patients was 57. Eightysix patients （41％） had a history of hypertension before anesthesia and 46 （53％） of these patients had some evidences of renal failure, coronary artery disease, diabetes mellitus and others which had been treated or under treatment preoperatively. Causes of postoperative hypertension include pain, hypercapnia, hypoxia, overhydration and hypothermia, but in most cases the cause is unknown. Then treatment may be symptomatic with vasodilator agents. Nitroglycerin is usually indicated, because of rapid onset of action and easiness in control of hypertension without altering myocardial contractility. Continuous epidural anesthesia is effective over longer period, while nytroglycerin is good for short-term management of postoperative hypertension. Furthermore, epidural anesthesia not only releive postoperative pain and control the hypertension but improve myocardial oxygen balance as nitroglycerin. |
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| Practice | Basic medicine |
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| Keywords | hypertension, postoperative, nitroglycerin, epidural anesthesia, β-blocker |
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