Effects of colloid preconditioning on hemodynamics of patients with laparoscopic colon surgery during pneumoperitoneum period / 中国医师进修杂志

ABSTRACT

Objective To investigate the effects of colloid preconditioning on hemodynamics of patients with laparoscopic colon surgery during pneumoperitoneum period.Methods Fifty patients withlaparoscopic colon surgery were divided into control group(group A,25 cases)and colloid preconditioning group(group B,25 cases)by random digits table.The mean arterial pressure(MAP),heart rate(HR),central venous pressure(CVP),cardiac index(CI),systemic vascular resistance index(SVRI),hemoglobin(Hb)and haematocrit(Hct)were recorded before anesthesia(T0),5 min after anesthesia(T1),5 min after pneumoperitoneum(T2),10 min after pneumoperitoneum(T3),15 min after pneumoperitoneum(T4)and 5min after pneumoperitoneum completely(T5).Results MAP in group A at T1-3[(68.7±5.3),(72.5±4.8),(73.1±6.3)mm Hg(1 mm Hg=0.133 kPa)]was significantly lower than that at T0[(81.7±6.1)mm Hg](P＜0.05).MAP in group B at T3,4[(93.2±5.8),(87.6±4.2)mm Hg]was significantly higher than that at T0[(80.2±5.6)mm Hg](P＜0.05).At T1,2,MAP in group A was significantly lower than that in group B[(79.8±5.4),(83.2±5.3)mm Hg](P＜0.05).CVP in group A at T2-4[(7.8±2.4),(8.1±2.2),(8.2±2.0)cm H2O(1 cm H2O=0.098 kPa)]was significantly higher than that at T0[(6.5±2.1)cm H2O](P＜0.05).CVP in group B at T1-4[(11.7±3.4),(13.5±3.6),(15.8±3.8),(16.6±3.7)cm H2O]was significantly higher than that at T0[(6.3±2.5)cm H2O](P＜0.05).There was significant differences in CVP at T1-4 between group A[group A at T1(5.6±2.2)cm H2O]and group B(P＜0.05).CI in group A at T2-4[(2.6±0.2),(2.1±0.1),(2.7±0.3)L/(min·m2)]was significandy lower than that at T0[(3.5±0.4)L/(min·m2)](P＜0.05).CI in group B at T2-4[(3.1±0.3),(2.9±0.3),(3.0±0.4)L/(min·m2)]was significantly lower than that at T0[(3.6±0.5)L/(min·m2)](P＜0.05).There were significant differences in C I at T2-4 between two groups.SVRI in group A at T2-4[(2853±432),(2918±510),(2718±436)dynes·s/cm5]was significantly higher than that at T0[(2318±236)dynes·s/cm5](P＜0.05).SVRI in group B at T2-4[(2756±391),(2718±402),(2694±382)dynes·s/cm5]was significantly higher than that at T0[(2356±372)dynes·s/cm5](P＜0.05).There was no significant difference in HR between two groups(P＞0.05).Hb and Hct in group B at T1-4[(123.6±11.5),(125.6±9.5),(126.1±10.2),(128.6±11.4)g/L and 0.339±0.037,0.337±0.036,0.322±0.041,0.312±0.040]were significantly lower than that at T0[(134.7±12.2)g/L and 0.371±0.039](P＜0.05).There were significant differences in Hb and Hct at T1-4between group B and group A[(131.8±10.2),(130.7±12.8),(131.6±14.3),(133.5±12.3)g/L and 0.360±0.042,0.359±0.041,0.361±0.040,0.360±0.036](P＜0.05).There was no significant different in Hb and Hct of group A(P＞0.05).Conclusion Colloid preconditioning may effectively maintain the stability of circulation,reduce blood viscosity,and improve microcirculation during the pneumoperitoneum period.