Acute Hypervolemic Infusion Can Improve Splanchnic Perfusion in Elderly Patients During Laparoscopic Colorectal Surgery
Qian-lin Zhu, Yun-xin Deng, Bu-wei Yu, Min-hua Zheng, Jue Jin
Department of Anesthesiology, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland)
Med Sci Monit 2018; 24:614-622
There is no adequate evidence on how the long duration of laparoscopic surgery affects splanchnic perfusion in elderly patients or the efficacy of acute hypervolemic fluid infusion (AHFI) during the induction of anesthesia. Our aim was to observe the effects of AHFI during the induction of general anesthesia on splanchnic perfusion.
MATERIAL AND METHODS: Seventy elderly patients receiving laparoscopic colorectal surgery were randomly divided into three groups: lactated Ringer’s solution group (group R), succinylated gelatin group (group G), and hypertonic sodium chloride hydroxyethyl starch 40 injection group (group H). Thirty minutes after the induction of general anesthesia, patients received an infusion of target dose of these three solutions. Corresponding hemodynamic parameters, arterial blood gas analysis, and gastric mucosal carbon dioxide tension were monitored in sequences.
RESULTS: In all three groups, gastric-arterial partial CO2 pressure gaps (Pg–aCO2) were decreased at several beginning stages and then gradually increased, Pg–aCO2 also varied between groups due to certain time points. The pH values of gastric mucosa (pHi) decreased gradually after the induction of pneumoperitoneum in the three groups.
CONCLUSIONS: The AHFI of succinylated gelatin (12 ml/kg) during the induction of anesthesia can improve splanchnic perfusion in elderly patients undergoing laparoscopic surgery for colorectal cancer and maintain good splanchnic perfusion even after a long period of pneumoperitoneum (60 minutes). AHFI can improve splanchnic perfusion in elderly patients undergoing laparoscopic colorectal surgery.
Keywords: Gelatin, Infusions, Intravenous, Splanchnic Circulation