CAJ | 학술논문

目的比较乳酸钠林格氏液用于硬膜外阻滞和全身麻醉下老年患者的容量动力学.方法择期手术的老年患者40例,性别不限,年龄66 ～ 86岁,体重45～86 kg,ASA分级Ⅰ或Ⅱ级.硬膜外阻滞组(EA组,n=20)于硬膜外注射局麻药前10 min开始恒速静脉输注乳酸钠林格氏液,全身麻醉组(GA组,n=20)于麻醉诱导前20 min开始恒速静脉输注乳酸钠林格氏液,乳酸钠林格氏液的容量为1000 ml,输注时间60 min.每隔5 min采集动脉血样,检测血红蛋白浓度,采用物质平衡规律动态分析公式计算血浆稀释度、单位体重血容量增加量及血容量扩张效率.结果与EA组比较,GA组输注乳酸钠林格氏液30-60 min时血浆稀释度、单位体重血容量增加量及血容量扩张效率升高(P＜0.05或0.01).结论与硬膜外阻滞相比,全身麻醉下老年患者乳酸钠林格氏液的血容量扩张效率更强.
목적 비교유산납림격씨액용우경막외조체화전신마취하노년환자적용량동역학.방법 택기수술적노년환자40례,성별불한,년령66 ～ 86세,체중45～86 kg,ASA분급Ⅰ혹Ⅱ급.경막외조체조(EA조,n=20)우경막외주사국마약전10 min개시항속정맥수주유산납림격씨액,전신마취조(GA조,n=20)우마취유도전20 min개시항속정맥수주유산납림격씨액,유산납림격씨액적용량위1000 ml,수주시간60 min.매격5 min채집동맥혈양,검측혈홍단백농도,채용물질평형규율동태분석공식계산혈장희석도、단위체중혈용량증가량급혈용량확장효솔.결과 여EA조비교,GA조수주유산납림격씨액30-60 min시혈장희석도、단위체중혈용량증가량급혈용량확장효솔승고(P＜0.05혹0.01).결론 여경막외조체상비,전신마취하노년환자유산납림격씨액적혈용량확장효솔경강.
Objective To compare the volume kinetics of lactated Ringer' s solution during induction of general and epidural anesthesia in elderly patients.Methods Forty ASA Ⅰ or Ⅱ patients,aged 66-86 yr,weighing 45-86 kg,undergoing elective surgery,were studied.In epidural anesthesia group (n =20),lactated Ringer' s solution was infused intravenously starting from 10 min before epidural anesthesia was performed with local anesthetics.In general anesthesia group (n =20),lactated Ringer' s solution 1000 ml was infused intravenously over 60 min starting from 20 min before induction of anesthesia.Arterial blood samples were obtained every 5 min for measurement of hemoglobin concentrations.The plasma dilution,volume increase,and volume expansion efficacy were calculated.Results The plasma dilution,volume increase and volume expansion were significantly higher at 30-60 min of lactated Ringer' s solution infusion in general anesthesia group than in epidural anesthesia group (P ＜ 0.05 or 0.01).Conclusion The volume expansion of lactated Ringer' s solution is greater in elderly patients during induction of general anesthesia than that during induction of epidural anesthesia.