Study On Safety And Efficacy Of Hydfoxyethyl Starch130/0.4Sodium Acetate Ringer’s Injection For Volume Thevapy In Patients With Non-cardiac Surgery

Objective Hydroxyethyl starch130V0.4(voluven) sodium chloride injection as control, to investigate hydroxyethyl starch130V0.4acetate Ringer’s injection for safety and efficacy in patients with the treatment of non cardiac volume operation under general anesthesia.Methods Select non-cardiac surgery under general anesthesia in60patients, estimated operation time more than2hours; The age ranged from18to65years old, ASA Ⅰ-Ⅱ: BMI18to29kg/m2,and were randomly divided into experimental group and control group, the experimental group hydroxyethyl starch130/0.4sodium acetate Ringer’s injection (group A), the control group using hydroxyethyl starch130/0.4Sodium Chloride Injection (B group). Preoperative determination of the patient’s blood, liver and kidney function, electrolytes, coagulation indicators. Into the operating room after the establishment of intravenous access, slow infusion of Ringer lactate injection2ml/kg after induction of anesthesia. Respectively intravenous midazolam alprazolam2mg+fentanyl2to4ug/kg+propofol2mg/kg+rocuronium0.6mg/kg endotracheal intubation. After induction of anesthesia, hemodynamic monitoring channels (including central venous catheter and radial artery), measurement of arterial blood gas indicators. After the end of induction into the maintenance phase of anesthesia, immediately give the subjects the15ml/kg hydroxyethyl starch130/0.4sodium acetate Ringer solution or hydroxyethyl starch130/0.4Sodium Chloride Injection, in1hour infusion is completed, the start of surgery after the end of the infusion. During maintenance of anesthesia medication: sevoflurane to maintain the MAC values ranging from0.8to1.3, if necessary, give rocuronium, PaCO2stable at30to40mmHg. During the infusion, such as systolic blood pressure less than80mmHg, intravenous ephedrine6mg Repeat as necessary, such as blood pressure greater than160mmHg, first to increase the amount of sevoflurane, deepen anesthesia, such as the effect of intravenous nicardipine0.5mg repeat as necessary. Such as heart rate less than50beats/min, intravenous atropine0.3mg, repeated if necessary. Such as heart rate greater than100beats/min, intravenous esmolol10mg Repeat as necessary. Drug infusion hemodynamic parameters measured every10minutes until the end of the infusion period. The end of the infusion, the determination of the amount of urine.15minutes after the end of the infusion Arterial blood gases, electrolytes, hematology and coagulation.Results At the start of capacity treatment, two groups of IAP, HR and CVP control values were not statistically different (P>0.05).During infusion of two group of hemodynamic parameters (systolic pressure, diastolic pressure, mean arterial pressure, central venous pressure and heart rate) compared with basal values showed no significant difference (P>0.05).Before and after the capacity treatment, no changes in A group of pH, SBE, HCO3-(P>0.05); B group of pH, SBE, HCO3-decreased significantly (P<0.05). Capacity before treatment, two sets of the above parameters between the two groups showed no significant difference (P>0.05), capacity after the end of treatment, there was significant difference between groups (P<0.05).Before and after the capacity treatment, two groups of serum K+, Na+, Ca2+, Mg2+were significantly decreased in comparison, group, there were significant differences (P<0.05). Comparisons between groups:the two group capacity before treatment, no significant difference of serum K+, Na+, Ca2+, Mg2+(P>0.05); after treatment, serum K+, Ca2+, Mg2+level, there is significant difference compared with that before treatment (P<0.05), no significant difference of serum Na+(P>0.05). Capacity after the end of treatment, serum CL-two group were compared with those before treatment (P,<0.05) increased in B group increased the amplitude of>A group. Comparisons between groups:before treatment, there was no significant difference in serum CL-two group (P>0.05), after treatment, there were significant differences (P<0.05).Before and after the capacity treatment, two groups of Hb and Hct were not significant (P>0.05). Liver, kidney function parameters showed no significant change (P>0.05).Conclusion The hydroxyethyl starch130/0.4sodium acetate Ringer’s injection and sodium chloride injection of hydroxyethyl starch130/0.4(voluven) used in general anesthesia patients noncardiac capacity expansion is similar to the effect of operation treatment, can maintain circulation stability.②and hydroxyethyl starch 130/0.4sodium chloride injection to compare, hydroxyethyl starch130/0.4sodium acetate Ringer’s injection capacity, to maintain the plasma electrolyte and acid-base balance is better than voluven, large infusion without hyperchloremic acidosis risk, applicable volume resuscitation dilution and hemorrhagic shock in the perioperative period of high capacity for blood treatment.③15ml/kg hydroxyethyl starch130/0.4sodium acetate Ringer’s injection capacity of treatment, liver, renal function and coagulation function had no significant effect, the general anesthesia operation capacity for noncardiac patients treatment is safe, effective.