对林格溶液的利尿反应在从全身麻醉中醒来后不久是正常的:回顾性运动分析
Robert G Hahn1,2, Joel Olsson3
1Research Unit, Södertälje Hospital, Södertälje, Sweden.
BJA open
|August 17, 2023
概括
在腹腔镜手术后,Ringer的酸盐溶液的消除受损,导致低血压. 在最初的术后几个小时内,支持血体积至关重要,以抵消液体再分配问题.
科学领域:
- 麻醉学 麻醉学
- 药理动力学 药理动力学
- 流体管理流体管理
背景情况:
- 在全身麻醉期间,Ringer的溶液排放量会减少.
- 手术后的林格溶液的排泄情况尚不清楚.
研究的目的:
- 为了研究林格酸盐溶液的术后药理动力学.
- 为了评估腹腔镜手术后的液体再分配和尿液分泌.
主要方法:
- 在腹腔镜胆囊切除术期间,12名患者接受了林格酸盐 (20毫升/千克).
- 在240分钟内对血红蛋白和尿液分泌的种群动力学分析.
- 麻醉前,麻醉后和志愿者数据的比较.
主要成果:
- 尿排泄率 (k10) 在术后显著增加,接近志愿者水平.
- 液体从血管外再分配到血 (k21) 仍然很低 (约10%的志愿者率).
- 流体回归障碍与排泄正常化相结合,导致术后低血压.
结论:
- 手术后的低血压可能是由于腹腔镜手术后的液体再分配不足造成的.
- 建议在拉巴镜胆囊切除术后2小时内支持血体积.
相关概念视频
Stages of General Anesthesia
497
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
497
Heart Failure Drugs: Diuretics
420
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
420
General Anesthesia: Overview
240
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
240
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Hemodialysis III: Nursing Management
49
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
49
Parenteral Anesthetics: Overview
154
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
154


