Effect Of "Nera-zero Fluid Balance" In L Aparoscopic Surgery For Colorectal Cancer

Objective:To evaluate the perioperative effects of a“near zero”fluid balance with liberal fluid administration in a patient undergoing laparoscopic colorectal surgery for colorectal cancer.Methods:Fifty patients undergoing elective radical resection of colorectal cancer were randomly divided into liberal fluid infusion group(U group)and near zero balance infusion group(Z group),each accounting for half of the total number of cases.Where in the patient's American Society of Anesthesiologists is graded I-II,aged between 45 and 75 years,and has a body mass index of less than 30 kg/m~2.Liberal infusion group:Fluid deficit+anesthesia compensatory vascular content volume expansion(CVE)+blood loss+loss+third space fluid loss.Near zero balance group:lactate ringer's solution was infused with the fluid deficit and maintenance amount after entering the room.The infusion speed was maintained at(1-3)ml/(kg.h),and the urine output was maintained at 0.5-1 ml/(kg.h).Hydroxyethyl starch 130/0.4sodium chloride injection or blood product was selected to supplement intraoperative hemorrhage.Arterial Blood gas analysis indexes were collected before operation(T1),1h after operation(T2)and 24h after operation(T3).The type and total amount of infusion,the type and total amount of anesthetics,the type and total amount of vasoactive drug were recorded along with renal function test 24 h before operation and 3 days after operation.Other parameters that were recorded:Coagulation function test and liver function test 24 h before operation and 1 day after operation,occurrence of hypotension and low pulse oxygen saturation within 24h postoperatively and the presence or absence of other complications.Results:There was no significant difference in sex,ASA grade,age,height,weight,anesthesia time and operation time between the two groups(p>0.05).There was no statistically significant difference between the two groups(p>0.05)in the amount of anesthesia drugs and blood loss.The total amount of infusion of crystalloids and colloids,urine volume and the total amount of anesthesia drugs plus infusion in group U were higher than those in group Z(p<0.05).There was no statistically significant difference in SBP,DBP,HR between the two groups at the same time point.The SBP of T1,T2,T3,T4,T5,in Z group was lower than that of T0(p<0.05).The DBP of T1,T3was lower than that of T0(p<0.05).There was no significant difference in DBP between T2,T4,T5 and T0(p>0.05).The HR of T1,T3,T4,andT5 were lower than that of T0(p<0.05).There was no significant difference in HR between T2and T0(p>0.05).SBP,DBP,HR in U group T1,T3,T4,T5 were significantly lower than those in T0(p<0.05).There was no significant difference in SBP,DBP,HR between T2 and T0(p>0.05).There was no significant difference in central venous pressure between the two groups(p>0.05).There was no significant difference in Cr,BUN,ALT and AST between the two groups at the same time(p>0.05).There was no significant difference in preoperative ALT and AST between the two groups(p>0.05).Postoperative ALT and AST in group U were higher than those in group Z(p<0.05).There was no significant difference in postoperative complications between the two groups(p>0.05).The first defecation time and postoperative cognitive function of the two groups were not statistically significant(p>0.05).The first time to pass flatus and postoperative hospital stay in group Z were less than those in group U(p<0.05).Conclusion:Zero balance infusion does not increase the incidence of perioperative complications and reduce postoperative hospital stay in patients undergoing colorectal cancer surgery.