CLC number: R4
On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 0000-00-00
Cited: 2
Clicked: 5445
LI Yu-hong, LOU Xian-feng, BAO Fang-ping. Dynamics of vascular volume and hemodilution of lactated Ringer’s solution in patients during induction of general and epidural anesthesia[J]. Journal of Zhejiang University Science B, 2006, 7(9): 738-744.
@article{title="Dynamics of vascular volume and hemodilution of lactated Ringer’s solution in patients during induction of general and epidural anesthesia",
author="LI Yu-hong, LOU Xian-feng, BAO Fang-ping",
journal="Journal of Zhejiang University Science B",
volume="7",
number="9",
pages="738-744",
year="2006",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2006.B0738"
}
%0 Journal Article
%T Dynamics of vascular volume and hemodilution of lactated Ringer’s solution in patients during induction of general and epidural anesthesia
%A LI Yu-hong
%A LOU Xian-feng
%A BAO Fang-ping
%J Journal of Zhejiang University SCIENCE B
%V 7
%N 9
%P 738-744
%@ 1673-1581
%D 2006
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.2006.B0738
TY - JOUR
T1 - Dynamics of vascular volume and hemodilution of lactated Ringer’s solution in patients during induction of general and epidural anesthesia
A1 - LI Yu-hong
A1 - LOU Xian-feng
A1 - BAO Fang-ping
J0 - Journal of Zhejiang University Science B
VL - 7
IS - 9
SP - 738
EP - 744
%@ 1673-1581
Y1 - 2006
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.2006.B0738
Abstract: Objective: To investigate the dynamics of vascular volume and the plasma dilution of lactated ringer’s solution in patients during the induction of general and epidural anesthesia. Methods: The hemodilution of i.v. infusion of 1000 ml of lactated ringer’s solution over 60 min was studied in patients undergoing general (n=31) and epidural (n=22) anesthesia. Heart rate, arterial blood pressure and hemoglobin (Hb) concentration were measured every 5 min during the study. Surgery was not started until the study period had been completed. Results: general anesthesia caused the greater decrease of mean arterial blood pressure (MAP) (mean 15% versus 9%; P<0.01) and thereby followed by a more pronounced plasma dilution, blood volume expansion (VE) and blood volume expansion efficiency (VEE). A strong linear correlation between hemodilution and the reduction in MAP (r=−0.50; P<0.01) was found. At the end of infusion, patients undergoing general anesthesia retained 47% (SD 19%) of the infused fluid in the circulation, while epidural anesthesia retained 29% (SD 13%) (P<0.001). Correspondingly, a fewer urine output (mean 89 ml versus 156 ml; P<0.05) and extravascular expansion (454 ml versus 551 ml; P<0.05) were found during general anesthesia. Conclusion: We concluded that the induction of general anesthesia caused more hemodilution, volume expansion and volume expansion efficiency than epidural anesthesia, which was triggered only by the lower MAP.
[1] Arndt, J.O., Höck, A.S., Stanton-Hicks, M., Stühmeier, K.D., 1985. Peridural anesthesia and the distribution of blood in supine humans. Anesthesiology, 63:616-623.
[2] Brauer, K.I., Prough, D.S., Traber, L.D., 1999. Antecedent hemorrhage increases plasma volume expansion (PVE) in response to 0.9% saline infusion in sheep. Anesth. Analg., 88:S135.
[3] Brown, D.L., 2000. Spinal, Epidural, and Gaudal Anesthesia. In: Miller, R.D. (Ed.), Anesthesia, 5th Ed. Churchill Livingstone, New York, p.1491-1515.
[4] Drobin, D., Hahn, R.G., 1996. Time course of increased hemodilution in hypotension induced by extradural anaesthesia. Br. J. Anaesth., 77:223-226.
[5] Ewaldsson, C.A., Hahn, R.G., 2005. Kinetics and extravascular retention of acetated Ringer’s solution during isoflurane and propofol anesthesia for thyroid surgery. Anesthesiology, 103(3):460-469.
[6] Hahn, R.G., 1992. Haemoglobin dilution from epidural-induced hypotention with and without fluid loading. Acta Anaesthesiologica Scandinavica, 36:241-244.
[7] Hahn, R.G., 1993a. Blood volume at the onset of hypotension in TURP performed during epidural anaesthesia. Eur. J. Anaesthesiol., 10:219-225.
[8] Hahn, R.G., 1993b. Increased haemodilution in hypotension induced by epidural anaesthesia. Acta Anaesthesiologica Scandinavica, 37:357-360.
[9] Kaye, A.D., Grogono, A.W., 2000. Fluid and Electrolyte Physiology. In: Miller, R.D. (Ed.), Anesthesia, 5th Ed. Churchill Livingstone, New York, p.1586-1603.
[10] Kempen, P.M., Tick, C., 1990. Hemodilution, regional block and Cesarean section. Regional Anesthesia, 15(1S):9.
[11] Lanne, T., Lundvall, J., 1989. Very rapid net transcapillary fluid absorption from skeletal muscle and skin in man during pronounced hypovolaemia circulatory stress. Acta Physiologica Scandinavica, 136:1-6.
[12] Li, Y.H., Zhu, S.M., Hahn, R.G., 2006. The kinetics of Ringer’s solution in young and elderly patients during induction of general and epidural anesthesia. Anesth. Analg., in press.
[13] Mark, J.B., Steele, S.M., 1989. Cardiovascular effects of spinal anesthesia. International Anesthesiology Clinics, 27:31-53.
[14] Olsson, J., Svensén, C.H., Hahn, R.G., 2004. The volume kinetics of acetated Ringer’s solution during laparoscopic cholecystectomy. Anesth. Analg., 99(6):1854-1860.
[15] Retzlaff, J.A., Tauxe, W.N., Kiely, J.M., 1969. Erythrocyte volume, plasma volume, and lean body mass in adult men and women. Blood, 33:649-667.
[16] Svensén, C., Hahn, R.G., 1997. Volume kinetics of ringer solution, Dextran 70, and hypertonic saline in male volunteers. Anesthesiology, 87:204-212.
[17] Tølløfsrud, S., Tonnessen, T., Skraastad, O., 1998. Hypertonic saline and dextran in normovolaemic and hypovolaemic healthy volunteers increases interstitial and intravascular fluid volumes. Acta Anaesthesiologica Scandinavica, 42:145-153.
[18] Tølløfsrud, S., Elgjo, G.I., Prough, D.S., 2001. The dynamics of vascular volume and fluid shifts of lactated Ringer’s solution and hypertonic-saline-dextran solutions infused in normovolemic sheep. Anesth. Analg., 93:823-831.
Open peer comments: Debate/Discuss/Question/Opinion
<1>