Effect of controlled hypotension on myocardial ischemia marker in eye-nose related surgery

ABSTRACT

We aimed to investigate the effect of different controlled hypotension levels on myocardial enzymes and myocardial ischemia protein in elderly hypertension patients, and then provide clinical evidence of suitable controlled hypotension level for them. Then, 45 elderly hypertension patients received elective eye-nose related surgery with nasal endoscope, who were randomly and evenly divided into three groups, including A, B and C groups, with mean arterial pressure [MAP] decreased by 20%, 30% and 40% respectively. The change of myocardial enzymes, myocardial ischemia modified albumin, score of surgical field quality and 12-lead electrocardiogram at different perioperative points were recorded. Then operative time, urine output and postoperative adverse complications of the patients were recorded too. Myocardial enzymes of group C were higher than that of both group A and B at T4, T5 points [p<0.05]; Myocardial ischemia modified albumin of group C were higher than that of group A and B at T2, T3, T4 and T5 points [p<0.05]; The score of surgical field quality of group A were higher than that of group B and C [p<0.05]; Operation time of group C is less than that of group A and B [p< 0.05]; The change of ST segment in group C is more obvious than that in group A and B [p<0.05]; The incidence of adverse complications of group C is higher than that of group A and B [p<0.05]. Controlled hypotension with MAP reduced by 30% brings minimum myocardial damage and fewer complications, while meeting the demand of surgical field. Thus it is an ideal controlled hypotension level and can be used for elderly hypertension patients safely