The Effects of Intravascular Volume Expansion on the Stability of Hemodynamic Responses in Patients undergoing Carotid Endarterectomy / 대한마취과학회지

ABSTRACT

BACKGROUND: During carotid endarterectomy, hemodynamic stability is very important to reduce the incidence of cerebral stroke and myocardial infarction. Therefore, we studied the effects of intravascular volume expansion using colloid solution on hemodynamic stability. METHODS: We studied 22 patients undergoing elective surgery under general anesthesia. Preanesthetic mean arterial blood pressure (MABP) and heart rate (HR) were checked, and the intraoperative target range was taken +/- 20% of these values. Following standardized anesthetic technique including intravenous induction with thiopental sodium and vecuronium, standard intraoperative monitoring and direct arterial blood pressure monitoring were instituted. Patients were randomly assigned to a Hartmann's solution group (group H, n = 11) or a pentastarch group (group P, n = 11). Distinct intraoperative episodes beyond the predetermined target range, and the number of episodes requiring interventional therapy were recorded. RESULTS: The pentastarch group had a significantly lower incidence of episodes requiring interventional drug therapy during the pre-reperfusion period. No difference was found between out of target incidents in MABP and HR. CONCLUSIONS: During carotid endarterectomy, the infusion of pentastarch solution reduced drug therapy requirement for hemodynamic stability during pre-reperfusion period only.