PDF(Pubmed)
Abstract：
UNASSIGNED: Patients undergoing gastrointestinal surgery often experience hypotension following general anesthesia induction due to insufficient volume. This study aimed to assess whether pre-rehydration guided by carotid corrected flow time (FTc) could mitigate post-induction hypotension induced by general anesthesia.
UNASSIGNED: Patients undergoing resection of gastrointestinal tumors were assigned to either the conventional treatment group (Group C) or the fluid treatment group based on FTc (Group F). Within Group F, patients were further divided into Group A (carotid FTc <340.7 ms) and Group B (carotid FTc ≥340.7 ms) based on pre-rehydration carotid FTc values. Group A patients received pre-rehydration with 250 mL of colloids (hydroxyethyl starch-HES) administered within 15 min until carotid FTc reached ≥340.7 ms to counteract hypovolemia prior to induction. Patients in Group B and Group C received a continuous HES infusion at a rate of 6 mL/kg/h 30 min before induction to compensate for physiological fluid loss. All patients received a perioperative background infusion of 3 mL/kg/h compound sodium chloride, with infusion rates optimized based on mean arterial pressure (MAP) and heart rate (HR). The incidence of post-induction hypotension was compared between Group C and Group F, as well as between Group A and Group B.
UNASSIGNED: The incidence of hypotension after induction was significantly lower in Group F compared to Group C (26.4% vs. 46.7%, respectively; p < 0.001). Patients in Group A received significantly more pre-rehydration, leading to a greater increase in carotid FTc values compared to Group B (336.5 ± 64.5 vs. 174.3 ± 34.1 ms, p = 0.002). However, no significant difference in carotid FTc values after pre-rehydration was observed between the groups. There was no significant difference in the incidence of hypotension after general anesthesia induction between Group A and Group B (22.9% vs. 28.8%, p = 0.535).
UNASSIGNED: Pre-rehydration based on FTc can effectively reduce the occurrence of post-induction hypotension in patients undergoing gastrointestinal surgery who present with insufficient volume.
UNASSIGNED: https://www.chictr.org.cn/showprojEN.html?proj=201481.
UNASSIGNED: Patients undergoing resection of gastrointestinal tumors were assigned to either the conventional treatment group (Group C) or the fluid treatment group based on FTc (Group F). Within Group F, patients were further divided into Group A (carotid FTc <340.7 ms) and Group B (carotid FTc ≥340.7 ms) based on pre-rehydration carotid FTc values. Group A patients received pre-rehydration with 250 mL of colloids (hydroxyethyl starch-HES) administered within 15 min until carotid FTc reached ≥340.7 ms to counteract hypovolemia prior to induction. Patients in Group B and Group C received a continuous HES infusion at a rate of 6 mL/kg/h 30 min before induction to compensate for physiological fluid loss. All patients received a perioperative background infusion of 3 mL/kg/h compound sodium chloride, with infusion rates optimized based on mean arterial pressure (MAP) and heart rate (HR). The incidence of post-induction hypotension was compared between Group C and Group F, as well as between Group A and Group B.
UNASSIGNED: The incidence of hypotension after induction was significantly lower in Group F compared to Group C (26.4% vs. 46.7%, respectively; p < 0.001). Patients in Group A received significantly more pre-rehydration, leading to a greater increase in carotid FTc values compared to Group B (336.5 ± 64.5 vs. 174.3 ± 34.1 ms, p = 0.002). However, no significant difference in carotid FTc values after pre-rehydration was observed between the groups. There was no significant difference in the incidence of hypotension after general anesthesia induction between Group A and Group B (22.9% vs. 28.8%, p = 0.535).
UNASSIGNED: Pre-rehydration based on FTc can effectively reduce the occurrence of post-induction hypotension in patients undergoing gastrointestinal surgery who present with insufficient volume.
UNASSIGNED: https://www.chictr.org.cn/showprojEN.html?proj=201481.
摘要：
■接受胃肠道手术的患者通常会由于体积不足而在全身麻醉诱导后出现低血压。这项研究旨在评估颈动脉校正血流时间（FTc）指导的预补液是否可以减轻全身麻醉诱导后低血压。
■接受胃肠道肿瘤切除术的患者被分为常规治疗组（C组）或基于FTc的液体治疗组（F组）。在F组中，根据补液前颈动脉FTc值,将患者进一步分为A组(颈动脉FTc<340.7ms)和B组(颈动脉FTc≥340.7ms).A组患者在15分钟内接受250mL胶体（羟乙基淀粉-HES）的预补液，直到颈动脉FTc达到≥340.7ms，以抵消诱导前的低血容量。B组和C组患者在诱导前30分钟以6mL/kg/h的速率连续输注HES以补偿生理液体损失。所有患者接受围手术期背景输注3mL/kg/h复方氯化钠，根据平均动脉压（MAP）和心率（HR）优化输注速率。比较C组和F组诱导后低血压的发生率,以及A组和B组之间。
■与C组相比，F组诱导后低血压的发生率显着降低（26.4％vs.46.7%,分别为；p<0.001)。A组患者接受了更多的预补液，与B组相比，导致颈动脉FTc值增加更大（336.5±64.5vs.174.3±34.1ms,p=0.002)。然而,两组间补液前后颈动脉FTc值无显著差异.A组和B组全身麻醉诱导后低血压的发生率差异无统计学意义（22.9%vs.28.8%,p=0.535)。
■基于FTc的预补液可以有效减少胃肠手术患者出现容量不足的诱导后低血压的发生。
■https://www.chictr.org.cn/showprojEN.html?proj=201481。
■接受胃肠道肿瘤切除术的患者被分为常规治疗组（C组）或基于FTc的液体治疗组（F组）。在F组中，根据补液前颈动脉FTc值,将患者进一步分为A组(颈动脉FTc<340.7ms)和B组(颈动脉FTc≥340.7ms).A组患者在15分钟内接受250mL胶体（羟乙基淀粉-HES）的预补液，直到颈动脉FTc达到≥340.7ms，以抵消诱导前的低血容量。B组和C组患者在诱导前30分钟以6mL/kg/h的速率连续输注HES以补偿生理液体损失。所有患者接受围手术期背景输注3mL/kg/h复方氯化钠，根据平均动脉压（MAP）和心率（HR）优化输注速率。比较C组和F组诱导后低血压的发生率,以及A组和B组之间。
■与C组相比，F组诱导后低血压的发生率显着降低（26.4％vs.46.7%,分别为；p<0.001)。A组患者接受了更多的预补液，与B组相比，导致颈动脉FTc值增加更大（336.5±64.5vs.174.3±34.1ms,p=0.002)。然而,两组间补液前后颈动脉FTc值无显著差异.A组和B组全身麻醉诱导后低血压的发生率差异无统计学意义（22.9%vs.28.8%,p=0.535)。
■基于FTc的预补液可以有效减少胃肠手术患者出现容量不足的诱导后低血压的发生。
■https://www.chictr.org.cn/showprojEN.html?proj=201481。
