陆军军医大学学报 (Mar 2023)
Effect of intraoperative blood pressure management on extubation time after laparoscopic gastrointestinal tumor surgery in patients with high cardiovascular risk
Abstract
Objective To explore the effect of intraoperative blood pressure management on the time of extubation after awakening from laparoscopic gastrointestinal tumor surgery in patients with high cardiovascular risk. Methods Clinical data of 198 patients who underwent laparoscopic gastrointestinal tumor surgery from July 2020 to November 2021 and met the inclusion criteria were collected from the medical record system of our hospital. According to the intraoperative blood pressure management, they were divided into routine blood pressure group (intraoperative mean arterial pressure ≥65 mmHg) and intensive blood pressure group (intraoperative mean arterial pressure ≥80 mmHg). Their extubation time, Steward recovery score, sleep, incidence of nausea and vomiting, hoarseness, pain and other conditions were recorded. For sensitivity analysis, multiple linear regression, inverse probability of treatment weighting (IPTW) and overlap weighting were respectively used to balance the influence of confounding factors, and the differences of main observation indexes of different blood pressure levels were analyzed. Standard mean difference (SMD) was used as the evaluation index of the equilibrium between groups. Linear regression was performed after propensity matching. To judge the relationship between intraoperative blood pressure management and postoperative extubation time, P < 0.05 was considered statistically significant. Results The extubation time was significantly shorter in the intensive blood pressure group than the routine blood pressure group (42.56±25.88 vs 79.15±39.45 min, P < 0.001). Conclusion Intraoperative intensive blood pressure management strategy can shorten the postoperative extubation time after laparoscopic gastrointestinal tumor surgery.
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