Influence Of Preinfusing Hypertonic Sodium Chloride Hydroxylethyl Starch 40 On Hemodynamic Conditions And Hemostasis During Anesthesia Induction

Objective To study the influence of preinjecting hypertonic sodium chloride hydroxylethyl starch 40(HSS40)on hemodynamic conditions,hemostasis, serum electrolytes and blood glucose.Methods Fifty-four patients(ASAâ… -â…¡) undergoing neurosurgery were randomly divided into 3 groups:group A(RL), group B(HES)and group C(HSS40)(n=18).Radial arteries and right jugular veins were catheterized under local anesthesia in all patients.Then RL,HES or HSS40 were injected at a speed of 4ml/kg within 30min for patients.General anesthesia was administered for all patients 60min after solution infusion.Mean arterial pressure(MAP),central venous pressure(CVP)and heart rate(HR)were recorded before solution infusion(T₀),immediate after infusion(T₁),3 0min(T₂) and 60min(T₃)after infusion,anesthesia induction(T₄)and 5 min(T₅)after endotrachial intubations.PT,APTT,FIB,ACT Onset,Clot Rate,PF,and serum K⁺,Na⁺,Ca²⁺,HCT,HB and blood glucose were measured at time-points of T₀-T₃ respectively.Results(1)After RL or HES infusion,HR increased obviously and MAP reduced obviously in T₄ and T₅(P＜0.05).After HSS40 infusion,HR reduced mildly and MAP increased slightly from T₁ to T₃,but without statistical significance(P＞0.05).CVP elevated obviously(P＜0.05). Compared to group A and B,reduction of HR and MAP,and increase of CVP in group C was significant in T₂-T₅(P＜0.05).(2)There were no significant difference(P＞0.05)in APTT,PT and FIB after RL infusion(P＞0.05).After HES infusion,PT obviously lengthened(P＜0.05)in T₂ and T₃.After HSS40 infusion,APTT and PT obviously lengthened(P＜0.05),FIB obviously reduced (P＜0.05).They had not yet been resumed in T₃(P＜0.05),but were all within the normal range.(3)There were no significant difference(P＞0.05)in ACT Onset,Clot Rate,PF among three groups.(4)After RL infusion,serum Na⁺ concentration mildly increased(P＜0.05).HCT,HB slightly decreased(P＜0.05) in T₂ and T₃ after HES infusion.After HSS40 infusion.serum K⁺ concentration in T₁ reduced(P＜0.05);serum Na⁺ concentration increased significantly,HCT and HB reduced(P＜0.05).There were no significant differences(P＞0.05)in serum Ca⁺ concentration and blood glucose among three groups.Conclusion The findings of the present study demonstrated that preinfusing HSS40(4ml/kg)is able to reduce cardiovascular responses to anesthesia induction without influence on hemostasis,platelet function,electrolytes and blood glucose,suggesting that HSS40 infusion is valuable for clinical application.