Attenuation of the hypertensive response to tracheal intubation in patients with severe preeclampsia: a UK postal survey.

摘要

The 2005 CEMACH report identified two deaths in which intracranial haemorrhage was thought to have occurred as a result of the hypertensive response to tracheal intubation during induction of anaesthesia for emergency caesarean section.' The report specifically recommended: "Anaesthetists should anticipate an additional rise in blood pressure at intubation in women with severe preeclampsia" and that "the anaesthetist should be given as much time as possible to try to prevent the presser effects of intubation". A recently published case series of 28 women in the USA supports the CEMACH report, suggesting that a systolic blood pressure of > 160 mmHg in this patient group is associated with an increased risk of intracranial haemorrhage.2 There is little evidence on which to base a recommendation on a specific agent for use in this situation and no national guidelines currently exist. We undertook a national postal survey of all UK consultant obstetric anaesthetists, approved by the Obstetric Anaesthetists' Association (OAA), to identify current practice in attenuating the hypertensive response.