To investigate the effect of
controlled hypotension by
urapidil on the predictive accuracy and diagnostic threshold of stroke volume variation (SVV) in hypertensive and non-hypertensive patients undergoing robotic hepatobiliary surgery.
Methods: Eighty patients undergoing robotic hepatobiliary surgery under
general anesthesia were divided into a
hypertension group (n=25) and a non-
hypertension group (n=38) according to whether or not
essential hypertension was present (excluding some cases that didn't meet requirements). The pump speed was at 6.0-7.0 µg/(kg﹒min), and the range of
hypotension was between 10%≤Δ systolic blood pressure (SAP)≤20%. Volume loading test was performed after artificial
pneumoperitoneum was established in reverse-Trendelenburg position. Hemodynamic indexes including heart rate (HR), SAP, cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke volume index (SVI) and SVV were recorded before and after infusion. Then the receiver operating characteristic (ROC) curves of SVV was drawn to determine the accuracy and diagnosis of SVV in predicting volume status in hypertensive and non-hypertensive patients after anti-Trendelenburg posture and
pneumoperitoneum.
Results: In the patients with
controlled hypotension by
urapidil, the area under the ROC curve of SVV in the
hypertension group was 0.974, the diagnostic threshold was 13.5%, the ROC curve of SVV in the non-
hypertension group was 0.832, and the diagnostic threshold was 15.5%.
Conclusion: SVV can accurately predict the volume status in the
hypertension group and the non-
hypertension group after
controlled hypotension in the anti-Trendelenburg position and fixed pneumoperitoneal pressure, and the SVV diagnostic threshold in the non-hypertensive group is higher than that in the hypertensive group.