Đánh giá thay đổi huyết động đo bằng USCOM ở bệnh nhân phẫu thuật chấn thương được truyền dịch tinh thể và dịch keo trước gây tê tủy sống

Abstract

Objective: Evaluation of changes in blood pressure, heart rate and cardiac output (CO), stroke volume (SV), stroke volume variation (SVV), systemic vascular resistance (SVR) in patients measured using USCOM 15ml/kg of 0.9% NaCl and 7ml/kg voluven 6% (HES 130/0.4) before spinal anesthesia for lower limb surgery. Subject and method: In a prospective study, randomized, single-blind, clinical trial on 60 patients at the Department of Anaesthetics, Vietnam-Germany Hospital from January 2014 to May 2014 equally divided into 2 groups: Group 1 (n = 30): Transmissions 15ml/kg of 0.9% NaCl for 20 minutes before spinal anesthesia. Group 2 (n = 30): 7ml/kg voluven 6% (HES 130/0.4) for 20 minutes before spinal anesthesia. Evaluate changes CO, SV, SVV, SVR differences in blood pressure, frequency heart at the time of T1-T10. Result: The patients with hypotension at the time of the higher group 1 with group 2 in the T1-T6 from time, higher blood pressure group 2 with group 1 at the time of T2, T3, T5, T6. CO at the time T2, T3, T4 group 2 higher in group 1. SVR after spinal anesthesia times lower group 1 with group 2 in T1, T2, T3, T5, T6. Higher SV group 2 with group 1 at the time of T2, T3, T4, T5, T6, T7. Group 2 lower SVV group 1. The rate of hypotension in group 2 with group 1 much higher recycling rate in 2nd hypotension no circumstances in group 2, group 1 with 8/30 patients (26.67%). Conclusion: Before spinal anesthesia, NaCl 0.9% does not increase CO, SV but increase SVV, voluven 6% CO, SV and SVR and maintain SVV stability during and after spinal anesthesia compared to the background. The rate of hypotension after spinal anesthesia in the group voluven 6% lower.