Effect of ANH and autologous transfusion on the onset-duration-recovery profile of pipecuronium / 中华麻醉学杂志

ABSTRACT

35%.The patients were premedicated with intramuscular phenobarbital 0.1g and atropine 0.5 mg. In group B and C 8-12 ml?kg-1 of blood was withdrawn from cubital vein in 10-15 min and equal volume of 6% hydroxyethyl was infused at the same speed simultaneously before anesthesia. In group C the blood shed during operation was collected and anticoagulated for reinfusion. Anesthesia was induced with fentanyl 4-6?g?kg-1 , propofol 2 mg?kg-1 and pipecuronium 0.1 mg?kg-1.The patients were mechanically ventilated after tracheal intubation and PETCO2 was maintained at 25-35 mm Hg. Anesthesia was maintained with 1%-3% isoflurane and intermittent iv boluses of fentanyl and pipecuronium. Lactated Ringer's solution was infused at 10-12 ml?kg-1.h-1 during operation in all patients. ECG, NIBP, SpO2, PETCO2 and CVP were monitored throughout anesthesia. Plasma protein, Hct and Hb were measured before and after ANH and after reinfusion of the shed blood. Neuromuscular function was assessed using a train-of-four stimulation (TOF). Onset time, peak effect time (when T1 decreased to 0), duration of action (from the end of pipecuronium injection to recovery of T1 to 25% of the control) of intubation dose and maintenance dose and recovery index (recovery of T1 from 25 % - 75%) were recorded.Results Demographic data including sex, age, body weight and height were not significantly different among the three groups. The vital signs were stable in the three groups. Plasma total protein and albumin concentrations, Hb and Hct decreased significantly after ANH in group B and C and were significantly lower than those in group A. After autologous transfusion there was no significant difference in plasma protein concentration and Hb between group A and B. Hb and Hct were significantly higher in group C than those in group A and B (P