Abstract
The present study was aimed to investigate the effects of infusion of different fluids combined with controlled hypotension on gastric intramucosal pH (pHi) and postoperative gastrointestinal function in patients undergoing hepatocarcinoma surgery. Forty-five patients (ASA II) scheduled for surgical resection of hepatocarcinoma undergoing controlled hypotension were randomly assigned to three groups and received infusion of 20 mL/kg Ringer's solution (R group), 6% HAES(H group) or 6% Voluven group (W group). Intragastric PgCO 2, pHi, hematocrit and hemoglobin were measured. The significant decrease of pHi and increase of PgCO 2 were produced at 1 and 2 h after controlled hypotension in the R group ( P < 0.05 or P < 0.01). The time of bowel movement after operation was shorter in the W group than the R group. Meanwhile, we also did not find obvious difference in blood gas indexes among the three groups. The infusion of HAES and Voluven during controlled hypotension could improve gastrointestinal perfusion and accelerate the recovery of postoperative gastrointestinal function.
Highlights
Hypervolemic hemodilution combined with controlled hypotension can lessen bleeding and save blood during surgery
Patients were randomly divided into three groups: 20 mL/kg Lactated Ringer’s solution group (R group), 6% HAES steril group (H group) and 6% Voluven group (W group)
All 45 patients in three groups completed the study protocol according to the anesthesia procedure, and all patients were induced by intravenous anesthesia, which was maintained by inhaled isoflurane successfully, and no patient was excluded
Summary
Hypervolemic hemodilution combined with controlled hypotension can lessen bleeding and save blood during surgery. It increases blood volume without increasing the cardiac load. It still remains unknown whether or not diluting blood under controlled hypotension will cause inadequate perfusion of vital organs and influence the microcirculation. Gastrotonometer can be used to evaluate localized blood flow of visceral vasculature. Compared with other conventional approaches, measurement of gastrointestinal mucosal pH using gastrotonometer is a considerably sensitive and specific method for estimation of microcirculatory blood flow and evaluation of the conditions of gastrointestinal blood perfusion and oxygenation[1]. The objective of this study is to investigate the effects of infusion of different liquids under controlled hypotension on gastric pH and gastrointestinal function after surgery using a gastrotonometer
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