อุบัติการณ์และปัจจัยที่มีผลต่อภาวะความดันโลหิตต่ำในผู้ป่วยกระเพาะอาหารทะลุ  ที่มารับการผ่าตัดโดยวิธีการให้ยาระงับความรู้สึกทั่วร่างกายในโรงพยาบาลสุราษฎร์ธานี

Wilawan Sawekchan; Daravan Rongmuang

Authors

Wilawan Sawekchan Suratthani hospital
Daravan Rongmuang Boromarajonani College of Nursing, Suratthani, Faculty of Nursing, Praboromarajchanok Institute

Keywords:

peptic ulcer perforation, general anesthesia, hypotension

Abstract

Introduction: Peptic ulcer perforation is a common surgical emergency. The treatment involves surgical closure of the perforation under general anesthesia. Without timely intervention, fluid loss into the interstitial space occurs leading to decreased blood volume and hypotension.

Research objectives: This study aims to investigate the incidence and factors influencing hypotension in patients with perforated peptic ulcers undergoing surgery and general anesthesia.

Research methodology: This retrospective descriptive study utilized data from medical records. A total of 150 patients who received surgery for peptic ulcer perforation and under general anesthesia at Suratthani Hospital from 2020 to 2022 was recruited to the study. Data collection was conducted using patient record forms. Statistical analysis employed descriptive statistics, chi-square tests, Fisher’s exact test, independent t-tests, and binary logistic regression.

Results: 1) The incidence of hypotension in patients with peptic ulcer perforation who received surgery under general anesthesia was 43.30%. 2) Females were 28.41 times more likely to develop hypotension compared to males (p = .014). An increase in age by one year was associated with a 4% higher likelihood of developing hypotension (p = .002). Additionally, patients with fever were 2.48 times more likely to experience hypotension than those without fever (p = .05). These factors could combine with the effects of predictive power for post-general anesthesia hypotension at 21.90%.

Conclusions: Age and fever are significant contributing factors to the development of hypotension following general anesthesia in patients with peptic ulcer perforation.

Implications: Nurse anesthetists should implement a risk assessment for the occurrence of hypotension in high-risk patients, especially older adults. Additionally, clinical practice guidelines should be established for managing patients with perforated peptic ulcers who are at high risk of hypotension. including preoperative assessment, preparation before anesthesia administration, and postoperative monitoring.

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