| ObjectiveStudy 1 We aimed to investigate whether there are inter-arm differences (XBP) and discuss the causes of these differences.Study 2 We aimed to investigate radial-brachial BP differences (⊿BP) and discuss the contributing factors.MethodsStudy 1 Three hundred and fifteen patients received general anesthesia during operation were enrolled in this study. Individuals with peripheral vascular diseases were excluded. The BP of bilateral brachial artery (bBP) were measured by the electrocardiogram monitor. And the arm measured first was determined randomly. We try to find the relevant causes leading to inter-arm bBP differences by Logistic method.Study 2 Methods were performed as study 1, the right brachial artery BP (bBP) and radial artery BP (rBP) were measured with appropriate cuffs. The arm measured first was determined randomly. Experimental groups were defined as follows:Group H (BP≥140/90 mmHg) and Group N (<140/90 mmHg); Group M (males) and Group F (females); Group Y1(≤44 years old), Group Y2 (45-59 years old) and Group Y3 (≥60 years old). We investigated the relationship between the bBP and rBP and its contributing factors.ResultsStudy 1 Mean±standard deviation (SD) of inter-arm differences in SBP (λSBP) was (1.9±10.2) mmHg (P<0.05), left systolic BP (LSBP) was higher in 56.8% of patients and lower in the right arm in 38.1% compared with right BP (RSBP).In the remaining 5.1%, SBP was identical in both arms. There were no significant differences in DBP or MAP between the two arm, respectively (P>0.05). Absolute differences of inter-arm BP increased with age. The logistic regression analysis demonstrated that inter-arm SBP and DBP of>10 mmHg were 27.3% and 12.4%, respectively. The λSBP and λDBP differences were related to age and arm circumstance.Study 2 The bBP values were significantly lower than rBP values (P<0.05). There were no significant ⊿BP between Group H and Group N (P>0.05). The radial-brachial systolic BP (⊿SBP) in males were higher than that in females (P<0.05), while the diastolic⊿BP (⊿DBP) and mean⊿BP (⊿MAP) were not shown different between Group M and Group F (P>0.05). Compared with Group Y1, ⊿SBP in Group Y3 were much higher (P<0.05). Moreover, rBP was positively correlated with bBP. Coefficients of determination for rSBP and bSBP were R2=0.621 for Group Y1, R2=0.77 for Group Y2, R2=0.692 for Group Y3, R2=0.703 for Group M, R2=0.824 for Group F, respectively. Coefficients of determination for rBP and bBP were R2=0.573 for DBP and R2=0.591 for MAP, respectively. The bBP can be estimated by subtracting ⊿BP[⊿SBP=16 (young),18(middle age),20 (old people) mmHg; 19 (males),16 (females) mmHg; ⊿DBP=13 mmHg;⊿MAP=14 mmHg] from rBP.ConclusionBP should be measured routinely in both arms of patients under general anesthesia. When the difference does exist, the arm with the higher BP should be monitored continually and effects of circumstance differences should be considered. To avoid the misjudgment of BP resulted from unilateral measurement. rBP measurement may be useful in situations in which bBP cannot be measured directly. |
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