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Arterial baroreflex sensitivity and blood pressure variabilities before and after carotid surgery

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Summary

Carotid surgery is frequently associated with postoperative blood pressure alterations. The role of baroreceptors with regard to these alterations was assessed in 50 patients by determining the pre- and postoperative mechanoreceptor sensitivity after Valsalva maneuver and intravenous injections of angiotensin and nitroglycerine as described by Smyth, Sleight and Pickering. In addition, blood pressure was monitored perioperatively and renin and aldosterone levels were measured. In patients with arterial hypertension a postoperative increase of receptor reactivity can be seen necessitating a reduction of antihypertensive therapy in more than 50% of cases. In normotensive patients no uniform response can be observed. A possible explanation for this effect might be the local increase of pressure in the operated vascular segment. The postoperative reintegration of receptor areas which had been adjusted to a reduced pressure level might induce a more sensitive response than can be seen for the remaining receptors, which usually are less responsive in hypertensive patients.

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References

  1. Aars H (1968) Aortic baroreceptor activity in normal and hypertensive rabbits. Acta Physiol Scand 72:298–309

    Google Scholar 

  2. Aars H (1969) Relationship between blood pressure and diameter and ascending aorta in normal and hypertensive rabbits. Acta Physiol Scand 75:397–405

    Google Scholar 

  3. Angell-James JE (1973) Characteristics of single aortic and right subclavian baroreceptor fiber activity in rabbits with chronic renal hypertension. Circ Res 82:149–161

    Google Scholar 

  4. Armstrong GG Jr, Porter H Jr, Langston JB (1961) Alteration of carotid occlusion response by anaesthesia. Amer J Physiol 201:297–306

    Google Scholar 

  5. Bagshaw RJ, Cox RH (1981) Baroreceptor reflexes and pulmonary hemodynamics during halothane-nitrous oxide anaesthesia in the dog. Anaesth Analg 60:701–712

    Google Scholar 

  6. Bove EL, Fry WJ, Gross WS, Stanley JC (1979) Hypotension and hypertension as consequences of baroreceptor dysfunction following carotid endarterectomy. Surgery 85:633–637

    Google Scholar 

  7. Cox PH, Bagshaw FJ (1979) Influence of anaesthesia on the response to carotid hypotension in dogs. Amer J Physiol 237:424–431

    Google Scholar 

  8. Davidson JK (1986) Anesthesia for major vascular procedures in the elderly. Clinics in Anaesthesiology 4:931–957

    Google Scholar 

  9. Duke PC, Wade JG, Hickey RF, Larson CPW (1976) The effect of age on baroreceptor reflex function in man. Canad Anaesth Soc J 23:111–117

    Google Scholar 

  10. Duke PC, Fownes D, Wade JG (1977) Halothane depresses baroreflex control of heart rate in man. Anaesthesiology 46:184–188

    Google Scholar 

  11. Duke PC, Trosky S (1980) The effect of halothane with nitrous oxide on baroreflex control of heart rate in man. Canad Anaesth Soc J 27:531–535

    Google Scholar 

  12. Elegbe ED, Seagard JL, Hopp FA, Kampine JP (1982) Isoflurane and the carotid sinus baroreceptor reflex. Anaesthesiology 57:297–305

    Google Scholar 

  13. Goldstein DS, Horwitz D, Reiser HR (1982) Comparison of techniques for measuring baroreflex sensitivity in man. Circulation 66:432–440

    Google Scholar 

  14. Giulini SM, Colombi A, Bonardelli S, Maffeis R, De Lucia M, Coniglio A, Tosoni F, Floriani M, Tiberio G (1990) Immediate detection of postreconstructive ischaemia by intra-operative Doppler ankle pressure index monitoring during aortic reconstructions. Eur J Vasc Surg 4:141–147

    Google Scholar 

  15. Giulini SM, Colombi A, Bonardelli S, Maffeis R, De Lucia M, Tosoni F, Coniglio A, Floriani M, Tiberio G (1990) Study of peripheral flow during successfull aortoiliac and aortofemoral prosthetic reconstructions by intraoperative above-ankle pressure index monitoring. Vascular Surgery 24:307–315

    Google Scholar 

  16. Hering HE (1924) Der Sinus caroticus an der Ursprungsstelle der Carotis interna als Ausgangspunkt eines hemmenden Herzreflexes und eines depressorischen Gefässreflexes. Münch Med Wochenschr 71:701–704

    Google Scholar 

  17. Jacobs MJ, Beckers RC, Joerning PJ, Slaaf DW, Reneman RS (1990) Microcirculatory haemodynamics before and after vascular surgery in severe limb ischemia — the relation to post-operative oedema formation. Eur J Vasc Surg 4:525–529

    Google Scholar 

  18. Mancia G, Mark AL (1983) Arterial baroreflexes in humans: Handbook of physiology, Vol III sec 2. Bethesda. American Physiological Society 755–793

    Google Scholar 

  19. Morrow CE, Espada R, Howell JF (1988) Operative and Long-term results of staged contralateral carotid endarterectomy: A personal series. Surgery 103:242–246

    Google Scholar 

  20. Morton M, Duke PC, Ong B (1978) Baroreflex control of heart rate in man awake and during enflurane and enflurane-nitrous oxide anaesthesia. Anaesthesiology 52:221–226

    Google Scholar 

  21. Ortenwall P, Lundstam S, Risberg B (1987) Prognostic value of consecutive peripheral pressure registration after reconstructive peripheral arterial surgery. Acta Chir Scand 153:587–592

    Google Scholar 

  22. Pickering GW, Gribbin B, Sleight P (1972) Comparison of the reflex heart rate response to falling and rising arterial pressure in man. Cardiovasc Res 6:277–283

    Google Scholar 

  23. Shionoya S, Matsubara J, Hirai M, Kawai S, Seko T, Sakurai T, Ban I (1983) Measurement of blood pressure, blood flow and flow velocity in arterial reconstruction of the lower extremity. Angiology 34:244–256

    Google Scholar 

  24. Smyth HS, Sleight P, Pickering GW (1969) Reflex regulation of arterial pressure during sleep in man. Circ Res 24:109–120

    Google Scholar 

  25. Towne JB, Bernhard VM (1980) The relationship of post-operative hypertension to complications following carotid endarterectomy. Surgery 88:575–579

    Google Scholar 

  26. Wilkinson PL, Stowe DF, Glautz SA, Tyberg JV (1980) Heart rate-systemic blood pressure relationship in dogs during halothane anaesthesia. Acta Anaesth Scand 24:181–186

    Google Scholar 

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Hirschl, M., Hirschl, M.M., Magometschnigg, D. et al. Arterial baroreflex sensitivity and blood pressure variabilities before and after carotid surgery. Klin Wochenschr 69, 763–768 (1991). https://doi.org/10.1007/BF01797615

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  • DOI: https://doi.org/10.1007/BF01797615

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