Effect of intravenous administration of gluco-alkali-potassium solution during percutaneous nephrolithotomy on acid-base balance, electrolyte, and BNP level

Abstract

Objective To observe the effect of the intravenous administration of gluco-alkali-potassium solution during percutaneous nephrolithotomy on acid-base balance, electrolyte, and BNP level. Methods Thourty ASA Ⅰor Ⅱpatients undergoing nephrolithotom were randomly divided into group T and group C, 20 cases for each group. All the patients took general anesthesia with endotracheal intubation. Normal saline was used as the perfusion solution. The hydraulic perfusion pump was used for continuous irrigation with a flow rate of 200-350 ml/min and a pressure of 2.94 kPa (30 cmH2O). During the perfusion period, glucoalkali-potassium solution was administrated intravenously in the group T, and sodium lactate ringer's solution in Group C. The formula for glucone-alkali-potassium solution was 440 ml 5% glucose, 50 ml 5% sodium bicarbonate, and 10 ml 10% potassium chloride. Arterial blood samples were collected for the detdction of pH, Na+, K+, Cl-, HCO3-, Glu, and HCT as well as the SBP, DBP, HR, and CVP of the patients were recorded before perfusion (T1), after 60 min perfusion (T2), and when perfusion was over (T3). Peripheral venous blood samples were extracted 1 day before and 1 day after surgery to detect the concentrations of brain natriuretic peptide (BNP) and troponin T (cTnT). Results The pH, K+, HCO3-, and Glu were higher and the Cl- was lower in group T than in group C at T3 (all P 0.05). The concentration of BNP was lower in group T than in group C 1 d after surgery (P<0.05). Conclusion The intravenous administration of gluco-alkali-potassium solution during percutaneous nephrolithotomy can prevent metabolic acidosis and hypokalemia caused by the absorption of perfusion solution and reduce postoperative BNP level. Key words: Percutaneous nephrolithotomy; Intravenous infusion; Gluco-alkali-potassium solution; Acid-base balance; Electrolyte; BNP