| Objective:Perioperative fluid therapy for every anesthesiologist during anesthesia isa very important part. However, modern fluid therapy still remains controversy.This study observed that thyroid surgery during different body fluid treatmentstrategies impact on the inner body environment. And it provides elective, short,non-gastrointestinal surgery fluid therapy for clinical study.Method:Selected40ASA physical status I-II class patients who intended to takethyroid surgery, between the ages of30-60years old. They were randomlydivided into four groups-A, B, C, D. All patients followed the routinepreoperative preparation before being taken into the operating room. Aftertaken into the operating room, the patients were given continuous ECG (ECG),heart rate (HR), blood pressure (BP), oxygen saturation (SpO2) monitoring. Allpatients underwent conventional method of anesthesia TIVA TCI. Patients inthe open access, were injected sodium acetate Ringer’s Injection by10ml/kg.h.anesthesia induction was performed after30mins. After the end of induction,Group A were injected20ml/kg.h sodium acetate Ringer’s Injection. Otherthree groups had been injected hydroxyethyl starch130/0.4Sodium ChlorideInjection at the same speed for30mins. After30mins the surgery began. Thistime group A and B were injected Compound Sodium Chloride Injection.Group C were injected invert sugar injection. Group D were injected sodiumacetate Ringer’s Injection. Four groups were input by10ml/kg.h speed. After60mins, the four groups were injected the compound sodium chloride solution by10ml/kg.h speed till the end of surgery. In this study, the induction ofanesthesia was set to T1immediately. The beginning of operation was set to T2.T3was set to the60mins of beginning operation. The end of the operation wasset to T4. In the four time points T1to T4were recorded HR, BP, ECG, SpO2separately, and collecting2ml arterial blood from each patient to test gasanalysis and blood glucose.Results:The40patients had completed the study successfully.In hemodynamics:There was no significant difference(P>0.05) in four groups of patients at T1BP and HR, which was no statistically significant. There was statisticallysignificant in the T2to T4time points. Compared with other groups, Group ABP was lower than baseline (P <0.05). The comparison of HCT, in the T2time point, HCT of each group was lower,which compared whit T1wasstatistically significant (P <0.05). A group of segments T3to T4, HCT returnedto the level before anesthesia (P>0.05). In T1, T2time, four groups showedno significant difference (P>0.05). T3, T4time, HCT of Group A was higherthan the other three groups (P <0.05).Aspect of electrolytes and blood sugar:Comparison of Na+, at T3and T4time points, Group C was lower than thebasic level of Na+(P <0.05), comparison among the four groups, Group C waslower than the other three groups (P <0.05). Comparison of K+, Group B&DK+in T2-T4segment is lower than the basic level (P <0.05). Group C at T2timepoint K+became lower (P <0.05). Then it recovered to the basic level (P>0.05)at the T3time point. Comparison of Ca2+, Group B, C and D inT2-T4time point,Ca2+was lower than the base level (P <0.05). Group A had no significant change (P>0.05). Comparison of blood glucose, Group C segment glucose washigher than the basic value in the T3-T4(P <0.05). There were no significantchanges among the other three groups (P>0.05)Acid-base balance:Comparison of PH: Group A PH value decreased in T3-T4segment (P<0.05), which was statistically significant. Group B, C and DPH valuedecreased (P <0.05) in T2-T4segments. Comparison of SB, Group A at T2-T4segment SB was higher than the other groups (P <0.05). Comparison of BE,Group A at T2-T3segment BE was higher than the other three groups (P<0.05)，T1, T4no time difference (P>0.05).Conclusion:1.Sodium acetate ringer’s solution composition close to the body environmentelectrolyte and PH value, intraoperative patients can maintain the stability ofthe environment inside the body;2.Invert sugar can provide energy for patients and can supplement K+concentration but will affect blood sugar;3.Hydroxyethyl starch sodium chloride can maintain130/0.4patients withintraoperative hemodynamic stability, but will cause the dilution of the blood,which reduces the K+, Ca2+dilutio... |
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