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Korean J Crit Care Med > Volume 13(1); 1998 > Article
Korean Journal of Critical Care Medicine 1998;13(1): 49-54.
근치적 경부 곽청수술을 받은 환자에서 술중 경동맥동 과민성과 술후 합병증에 대한 후향적 연구
김태일, 임혜자, 장성호, 김난숙
고려대학교 의과대학 마취과학교실
Intraoperative Carotid Sinus Hypersensitivity and Postoperative Complication of Radical Neck Dissection Retrospective Study
Tae Il Kim, Hae Ja Lim, Seong Ho Chang, Nan Sook Kim
Department of Anesthesiology, Korea University College of Medicine, Seoul, Korea.
ABSTRACT
BACKGOUND: Postoperative complications in the geriatric patients undergoing radical neck dissection are generally considered to be more severe than young patients. The incidence of carotid sinus hypersensitivity in elderly patients is also considered to be higher than the young. The comparison between old (above 65 years) and young (below 65 years) aged groups about intraoperative carotid sinus hypersensitivity and postoperative complication is necessary for safe anesthesia. METHODS: Sixty five adult patients, of either sex, regardless of age, given radical neck dissection from January 1990 to January 1998, were investigated for the incidence of intraoperative carotid sinus hypersensitivity and postoperative hypertension by way of retrospective chart review. The authors also examined the postoperative complications such as high fever, pulmonary, cardiac and renal complications, cerebrovascular diseases and neurologic injuries. RESULTS: The incidence of intraoperative carotid sinus hypersensitivity were 28% in elderly patients (n=25), 10% in young patients (n=40) but there was no statistical significance. The incidence of postoperative hypertension were 79.1% in patients with hypertension history, 34.1% in patients without hypertension history and there was statistical significance between the two groups (P=0.001). The incidence of postoperative pulmonary complication were 44% in elderly patients, 20% in young patients, and there was also statistical significance between the two groups (P=0.038). There was no statistical significance in the incidence of postoperative high fever above 38.5degrees C between the two groups (p=0.059). CONCLUSION: After the radical neck dissection, the geriatric patients had a greater incidence of postoperative pulmonary complications than young patients and the most relating factor to postoperative hypertension was previous history of hypertension. Therefore optimal preoperative preparations for the hypertensive patients and the prevention and immediate treatment of the postoperative pulmonary complications in geriatric patients are very important during the radical neck dissection.
Key Words: Blood pressure; hypertension; Complications; infection; postoperative; pulmonary
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