ABSTRACT
Objective To investigate the therapeutic effect of goal-directed fluid therapy on perioperative volume therapy in patients with placenta previa during perioperative period. Methods Eighty patients undergoing cesarean section were randomly divided into 2 groups(n=40 in each group):the conventional therapy group(N group)and the target management of resuscitation group(G group). Patients in G group were connected the Flo-Trac/Vigileo monitoring system to obtain the information of△SV and CI which were used to guide goal-directed flu-id therapy. Hemodynamics,blood coagulation indexes and lactic acid content in different periods of operation were recorded. Results Compared with N group,colloid infusion volume,HR,△SV,the amount of phenylephrine, PT,APTT and TT were decreased,but urine volume,CVP,CI and MBP of each time point and FIB were mark-edly increased(P < 0.05,respectively). Conclusion The application of FloTrac/Vigileo monitoring system for goal-directed fluid therapy,real-time monitor and effectively maintain hemodynamics in patients with dangerous placenta previa during perioperative period,which can improve the postoperative coagulation function and is better than the conventional rehydration capacity.
ABSTRACT
Objective To observe the effect of a variety dosage of dexmedetomidine on circulatory and cognitive func?tions in elderly patients who underwent hip orthopedic surgery. Methods A total of 120 patients who underwent hip ortho?pedic surgery, with age over 65 years old were recruited from 06/2013 to 09/2014 and were administered intravenously dex?medetomidine after epidural anesthesia. Based on the dosage of dexmedetomidine, patients were randomly divided into 3 groups with 40 cases in each group:Group A were given 0.2μg·h-1·kg-1 dexmedetomidine;Group B were given dexmedeto?midine 0.4μg · h-1 · kg-1, and group C were given 0.6μg · h-1 · kg-1. The heart rate (HR),mean arterial pressure (MAP), and pulse oxygen saturation (SpO2) were recorded at 6 time points, including the time entering operating room (T0), 10 min (T1), 20 min (T2) after drug administration, the time of drug withdrawal (T3), 10 min after drug withdrawal (T4) and the terminal time of surgery (T5) respectively. Cognitive function was evaluated by mini-mental state examination (MMSE) at the time points of 24 hours before surgery (t1), 12 hours (t2), 24 hours (t3), and 72 hours (t4) after surgery. Results All 3 groups of pa?tients show no significant difference of MAP, HR and SpO2 at T0 (P>0. 05).A significant decrease in MAP and HR were ob?served in Group C at T2 and T3 time points compared to those in Group A or Group B (P 0.05). However, compared to that in group A or group C, MMSE increased significantly at time point T2, T3 in group B (P<0.05). In addition, compared to group A or group C, the pa?tients in group B exhibited lower incidence of postoperative cognitive function disorder (P < 0.05). Conclusion Continu?ous intravenous infusion of Dexmedetomidine can be used in elderly patient who underwent hip orthopedic surgery at the dose of 0.4μg·h-1·kg-1 safely with little interference to circulatory and cognitive function in perioperative period.