20 19 database of clinical anesthesiology: indications and contraindications of controlled hypotension

? 20 19 Tianjin Hospital Recruitment | Physical Examination Announcement and Publicity Summary (continuously updated)

I. signs

The purpose of controlled hypotension is to reduce blood loss and blood transfusion, improve the operating site conditions and increase the safety of surgery. In recent years

In recent years, with the improvement of blood pressure control technology and drugs, the shortage of blood sources and the understanding of complications of allogeneic blood transfusion, its indications are also expanding. Including:

1. Surgery with more bleeding and difficult hemostasis is expected, such as giant meningioma and pelvic surgery.

2. Vascular surgery, such as aortic aneurysm, patent ductus arteriosus and intracranial vascular malformation.

3. Microsurgery, fine surgery with narrow area and clear surgical field, such as middle ear surgery and nasal endoscopic surgery.

4. A large number of blood transfusion difficulties or blood transfusion contraindications; Or those who refuse blood transfusions because of their religious beliefs.

5. Excessive increase of blood pressure, intracranial pressure and intraocular pressure during anesthesia may lead to serious adverse consequences.

Second, contraindications

Anesthesiologists lack the knowledge and experience of controlled hypotension, which can be regarded as an absolute contraindication. In addition, the following situations

Should be disabled or used with caution:

1. Substantial lesions of important organs, such as cerebrovascular diseases, cardiac insufficiency, severe liver or renal insufficiency.

2. Severe vascular diseases, hypertension, arteriosclerosis, peripheral vascular claudication and organ perfusion.

3. Severe anemia or hypovolemia.

4. Patients with increased intracranial pressure are prohibited from lowering blood pressure before craniotomy.

5. For patients whose oxygen transport in the body, organs and tissues is obviously reduced, the advantages and disadvantages of intraoperative controlled hypotension should be carefully weighed and used as appropriate.

Which of the following is not a contraindication to controlled hypotension? ( )

A. Severe liver dysfunction

B. Patients with coagulation dysfunction

C. increased intracranial pressure

D. Patients with coronary heart disease

E. Bilateral renal artery stenosis

Answer B. Analysis: Patients with coagulation dysfunction are prone to bleeding during operation, and controlled hypotension can effectively reduce the amount of bleeding, so controlled hypotension is needed.

?