ABSTRACT
Objective To evaluate the development of extravascular leakage of 6％ hydroxyethyl starch (HES) 130/0.4 when used for acute hemodilution in the pediatric patients undergoing open heart surgery.Methods Forty-eight American Society of Anesthesiologists physical status Ⅰ or Ⅱ pediatric patients,aged 2-12 yr,weighing 12-53 kg,scheduled for elective surgical repair of ventricular or atrial septal defect,were divided into 2 groups (n =24 each) according to age:preschool group (2 yr ≤ age ≤ 6 yr) and school-age group (6 yr＜age ≤ 12yr).After anesthesia induction and endotracheal intubation,a volume of 6％ HES 130/0.4 equivalent to 10％ of the blood volume was infused via the central veins at 0.5 ml · kg-1 · min-1 in two groups.Immediately before infusion of HES (T0) and at 15 and 30 min after the end of infusion (T1,2),blood samples were collected fron the central vein for determination of plasma colloid osmotic pressure (COP) and hemnoglobin (Hb) concentrations.The concentrations of 6％ HES 130/ 0.4 in plasma at T1 and T2 and in urine at T2 were measured by the anthranone colorimetric method.Results Compared with the baseline value at T0,the concentrations of Hh in plasma were significantly decreased at T1,2 in preschool group,and the concentrations of Hb in plasma were significantly decreased and plasma COP was increased at T1,2 in school-age group (P＜0.05).There were no significant differences in plasma Hb concentrations or COP at each time point between two groups (P＞0.05).The plasma 6％ HES 130/0.4 concentrations were significantly lower at T2 than at T1 in two groups (P＞0.05).Compared with school-age group,the plasma 6％ HES 130/0.4 concentrations were significantly decreased at T1,2 in preschool group (P＜0.05).There was no significant difference in 6％ HES 130/0.4 concentrations in urine between the two groups (P＞0.05).Conclusion When 6％ HES 130/0.4 is used for acute hemodilution,extravascular leakage happens after acute hemodilution and is more obvious in the preschool pediatric patients undergoing open heart surgery.
ABSTRACT
Objective To compare the effects of different doses of sufentanil on hemodynamic response to anesthesia induction in patients with hypertension undergoing coronary artery bypass graft (CABG). Methods 45 ASAⅡor Ⅲ patients aged 46~65years old and weighing 58~79kg scheduled for elective undergoing CABG surgery under general anesthesia requiring tracheal intubation were randomly divided into 3 groups(n=15 each)according to different doses of sufentanil. The patients were premedicated with intravenous scopolamine 0.005mg/kg and midazolam 0.05mg/kg. Anesthesia was induced with etomidate 0.3mg/kg and rocuronium 0.6 mg/kg and then received 1.0?g/kg(group S1) or 1.2?g/kg (group S2) or 1.5?g/kg (group S3) of sufentanil injected intravenously slow-moving at 3 min before orotracheal intubation. ECG,HR,BIS,BP and SpO2 were monitored and recorded before induction of anesthesia(the baseline values T0),and after induction of anesthesia and before intratracheal intubation instantly (T1),1 min(T2),5 min (T3)and 10 min (T4) after intratracheal intubation.Results There were no significant differences between 3 groups with respect to age,sex,body weight and hypertension class. Hemodynamic variables were significantly changes at 3 groups at T1-4 than T0(P