J.Jpn. Surg. Soc.. 61(7): 923-942, 1960
Original article
THE PROBLEMS OF HYPERTENSION IN SURGERY AND STUDIES IN POSTOPERATIVE HYPERTENSION
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Department of Surgery, Chiba University School of Mcdicine. (Director: Prof. Komei NAKAYAMA) Tadayasu IIMORI |
The definition of hypertension is blood pressure elevation over 140/80 mmHg in early morning.
Among 526 cases, 83 cases are over 180 mmHg of systolic blood pressure and 3 are over 120 mmHg of diastolic blood pressure.
Abnormal findings of ECG was mostly myocardial damage, and renal functions are more disturbed as the blood pressure elevates higher.
By classification of Keith-Wagener those are mostly class II, and 9 cases are class III. Careful attention must be paid to the fact that the blood pressnre is reduced by spinal anesthaesia.
Eight cases are dead due to hypertensive diseases in the postoperative stage. The author tried to definite the contra-indications refer to these results, over 120 mmHg of diastolic blood pressure, cardiac insufficiency, under 10 of renal index by Becher, under 20% of PSP-test and over class III of Keith-Wagener.
In spite of normal blood pressure level preoperatively, it suddenly elevates after operation extraordinary, so the author addresses this state "the postoperative hyper-tension".
There were 201 cases which were over 160 mmHg of systolic blood pressure after operation. Blood pressure elevation suddenly appeares immediately after operation and its duration is mostly within 5 days.
Hypertension and postoperative hypertension are like each other in quality, but different in degree.
According to analysis of circulatory dinamics by Wezler-Boeger, abnomal values are changed to normal after operation, and volume-elasticity of the aorta increases extraodinary with inprovement of the other values from abnormal to normal. Therefore the blood pressure elevates so remarkably.
This fact is to consider that the overcompensation of the adaptation for stress was resulted.
It is necessary to reduce the blood pressure to prevent the apoplexia, hypertensive encephalopathy and postoperative bleeding.
(Author's abstract)
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